Form K-40 - Kansas Individual Income Tax -2004 Page 2
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TAX: Enter the income tax amount from line 12 ___________________
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13. Credit for taxes paid to other states (See instructions, page 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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14. Credit for child & dependent care expenses (See instructions, page 17). . . . . . . . . . . . . . . . . . . . . . .
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15. Other credits (Enclose all appropriate credit schedules) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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16. Total tax credits (Add lines 13, 14 and 15) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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17. Income tax balance after credits (Subtract line 16 from line 12; cannot be less than zero) . . . . .
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18.
Use tax due (See instructions on page 18). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
NEW!
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19. Total Tax Balance (Add lines 17 and 18). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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20. Kansas income tax withheld from W-2, 1099, or K-19 (Enclose K-19; see instructions) . . . . . . .
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21. Estimated tax paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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22. Amount paid with Kansas extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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23. Earned income credit (See instructions, page 18). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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24. Refundable portion of tax credits (Enclose all appropriate credit schedules) . . . . . . . . . . . . . . . . . . . .
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25. FOOD SALES TAX REFUND (You must meet the qualifications listed on page 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
For an ORIGINAL return, skip to line 28. For an AMENDED return, complete lines 26 and/or 27 before continuing to line 28.
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26. Payments remitted with original return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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27. Overpayment from original return (This figure is a subtraction; see instructions, page 18). . . . . .
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28. Total refundable credits (Add lines 20 through 26 and subtract line 27) . . . . . . . . . . . . . . . . . . .
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29. UNDERPAYMENT (If line 19 is greater than line 28) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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30. Interest (See instructions, page 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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31. Penalty (See instructions, page 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Check here if you were engaged in
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32. Estimated Tax Penalty (See instructions, page 18) . . . .
commercial farming or fishing in 2004.
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33. AMOUNT YOU OWE (Add lines 29 through 32. Include amounts from lines 36 and 37 if
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applicable.) See payment options on page 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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34. OVERPAYMENT (If line 19 is less than line 28). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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(Enter the amount of line 34 you wish to be applied to your 2005 estimated tax) . . .
35. CREDIT FORWARD
If you wish to donate to either the Chickadee Checkoff or the Senior Citizens Meals on Wheels Program, enter the amount
of your donation on the appropriate line. This donation will reduce your refund or increase the amount you owe.
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36. CHICKADEE CHECKOFF (Kansas Nongame Wildlife Improvement Program). . . . . . . . . . . . . .
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37. SENIOR CITIZENS MEALS ON WHEELS CONTRIBUTION PROGRAM . . . . . . . . . . . . . . . . . .
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38. REFUND (Subtract lines 35, 36 and 37 from line 34) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I authorize the Director of Taxation or the Director's designee to discuss my return and enclosures with my preparer.
I declare under the penalties of perjury that to the best of my knowledge and belief this is a true, correct, and complete return.
Signature of taxpayer
Date
Signature of preparer other than taxpayer
Phone number of preparer
Tax preparer's EIN (Employer
Identification Number) OR
If joint return, BOTH taxpayer and spouse must sign even if only one had income
SSN (Social Security Number)
ENCLOSE any necessary documents
KANSAS INCOME TAX
MAIL TO:
KANSAS DEPARTMENT OF REVENUE
with this form. DO NOT STAPLE.
915 SW HARRISON ST
TOPEKA, KS 66699-1000
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