Form K-40h - Kansas Homestead Claim - Kansas Department Of Revenue - 1998

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K-40H

KANSAS HOMESTEAD CLAIM

1998

30098

Rev. (8/98)

FILE THIS CLAIM AFTER DECEMBER 31, 1998, BUT NO LATER THAN APRIL 15, 1999

First four letters of

Please use UPPER

Social Security number

claimant’s last name

CASE letters

of claimant

First name and Initial of claimant

Last Name

IMPORTANT:

Telephone number of claimant

- -

Check this

box if name or

address has

changed

Home address (number and street or rural route)

Check this box if claimant is deceased (see

instructions) Date of Death ______/______/______

City

State

Zip Code

County Abbr.

Check this box if this is an amended claim

YOU MUST HAVE BEEN A RESIDENT OF KANSAS THE ENTIRE YEAR OF 1998

Month

Day

Year

Answer ONLY the questions that apply to you:

Age 55 or over for the entire year. Enter date of birth. (Must be prior to 1943). . . . . . . . . . . . . . . . . .

Disabled or blind for the entire year. Enter date of disability.

ATTACH Social Security Statement

or Schedule DIS

(See instructions on page 15)

Youngest dependent child who resided with you and was under 18 years of age for the entire year.

Child’s name ___________________________ Enter date of birth. (Must be prior to 1998)

ENTER YEARLY TOTALS ONLY. SEE INSTRUCTIONS BEGINNING ON PAGE 16

1998 Wages __________________ + 1997 Federal Earned Income Credit __________. Enter Total.

All taxable income other than wages and pensions. (Do not include net operating losses and capital losses)

Social Security, SSI, SSDI, and railroad retirement (Add back medicare deductions). . . . . . . . . . . . . . . .

All pensions, annuities, and veterans benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

TAF payments, general assistance, worker’s compensation, disability, grants and scholarships. . . . . . . .

All other income. (Also include income of others who resided with you in 1998) . . . . . . . . . . . . . . . . . . . .

10.

TOTAL HOUSEHOLD INCOME (Total of lines 4 through 9) (If line 10 is more than $25,000, you do not

qualify for a refund.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

, ,

ATTACH 1998 PROPERTY

11.

OWNER - 1998 general property taxes. (See instructions, on page 17)

TAX STATEMENT

, ,

RENTER - Enter total of line 5 amounts from RNT Schedule(s) . . . . . . . . .

12.

ATTACH RNT SCHEDULE(S)

Total of lines 11 and 12. Do not enter more than $600 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13.

14.

Using your total household income on line 10 and the chart on page 6, enter your refund percentage. . . . . . . . . . . . . . . .

Homestead refund (Multiply line 13 by percentage on line 14). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15.

I declare under the penalties of perjury that to the best of my knowledge and belief, this is a true, correct and complete claim.

_______________________________________________________ __________________

____________________________________________

Mail to: Kansas Homestead Claim

Please allow 10 to 12 weeks processing time for your refund.

Kansas Department of Revenue, 915 SW Harrison St.,

If you are a renter, you should allow an additional 6 to 8

weeks so your rent can be verified with your landlord.

Topeka, KS 66699-2000

PLEASE COMPLETE REVERSE SIDE

FOR OFFICE