Form K-130v - Privilege Tax Payment Voucher - 2005

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Voucher is located at the bottom of the page.
DO NOT SEND A PHOTOCOPY OF THIS VOUCHER
or risk the chance of our automated system not capturing your data correctly.
SEND THE ORIGINAL
K-130V
2005 KANSAS
FOR OFFICE USE ONLY
PRIVILEGE TAX
(Rev. 8/04)
PAYMENT VOUCHER
-
Employer
For the taxable year beginning __________________ , 2004; ending _________________ , 20_____
Identification
Number
Corporation Name
Corporation Address
Name or
Amended
Extension
Address
Payment
Payment
Change
Zip Code
City, Town, or Post Office
State
Name of Contact Person
Phone Number
$
PAYMENT
,
,
.
AMOUNT
Please make check or money order payable to: Kansas Privilege Tax
DO NOT SUBMIT PHOTOCOPIES OF THIS FORM


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