Form K-40 - Kansas Individual Income Tax -2004
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1
22004
K-40
114504
KANSAS INDIVIDUAL INCOME TAX
(Rev. 8/04)
and/or FOOD SALES TAX REFUND
DO NOT STAPLE
Your First Name
Initial
Last Name
Enter the first four letters of your last name.
- -
Use ALL CAPITAL letters.
Spouse's First Name
Initial
Last Name
Your Social
Security number
Mailing Address (Number and Street, including Rural Route)
School District No.
Enter the first four letters of your spouse's
-
-
last name. Use ALL CAPITAL letters.
City, Town, or Post Office
Zip Code
County Abbreviation
State
Spouse's Social
- -
Security number
Daytime
If your name or address has
If taxpayer (or spouse if filing
telephone
changed since last year, mark
joint) died during this tax year,
number
an "X" in this box
mark an "X" in this box
Reason for amending your 2004 original Kansas return:
Mark this box if you are filing this as
an AMENDED 2004 Kansas return:
Amended affects
Amended Federal
Adjustment by
NOTE: This form cannot be used for tax years prior to 2004.
Kansas only
tax return
the IRS
Filing Status (Mark ONE)
Residency Status (Mark ONE)
Exemptions
Number of exemptions claimed
Single
Resident
on your 2004 federal return
. . . . . . .
Married filing joint
Nonresident or Part-year resident
(Even if only one had income)
If filing status is head of
from ___/___/___ to ___/___/___
household, add one exemption . . . . . . .
Married filing separate
(Complete Schedule S, Part B)
Head of household
Total Kansas exemptions . . . . . . .
-
If amount is negative, shade the minus (-) in box.
Example:
-
,
,
.
00
1. Federal adjusted gross income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
-
,
,
.
00
2. Modifications to Federal adjusted gross income (From Schedule S, Part A, line A15). .
-
,
,
.
3. Kansas adjusted gross income (Line 2 added to or subtracted from line 1; see
00
instructions, page 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
,
,
.
00
4. Standard deduction OR itemized deductions (See instructions, page 15). . . . . . . . . . . . . . . . . . . .
,
.
00
5. Exemption allowance ($2,250 x number of exemptions claimed) . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . .
,
,
.
00
6. Total deductions (Add lines 4 and 5). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
,
,
.
00
7. Taxable income (Subtract line 6 from line 3. If less than zero, enter 0.) . . . . . . . . . . . . . . . . .
,
,
.
00
8. Tax (From Tax Tables or Tax Computation Schedules beginning on page 25) . . . . . . . . . . . . . . .
%
9. Nonresident allocation percentage (From Schedule S, Part B, line B23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
,
,
.
00
10. Nonresident tax (Multiply line 8 by line 9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
,
,
.
00
11. Kansas tax on lump sum distributions (Residents only - see instructions, page 16). . . . . . . . . . . .
,
,
.
00
12. TOTAL INCOME TAX (Residents: add lines 8 & 11; Nonresidents: enter amount from line 10). . .
PLEASE COMPLETE REVERSE SIDE
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