Fillable Form Kw-7a - Kansas Nonresident Owner Withholding Affidavit printable pdf download

KW-7A

KANSAS

(Rev. 9/12)

Nonresident Owner Withholding Affidavit

PART A - PARTNERSHIP, S CORPORATION, LLC OR LLP

Partnership, S Corporation, LLC or LLP

Employer Identification Number (EIN)

Street Address, City, State & Zip Code

PART B - WITHHOLDING TAX EXEMPTION

Nonresident Owner’s Name

Social Security Number (If not an individual, enter the EIN)

Street Address, City, State & Zip Code

I, _____________________________________, as a partner/shareholder/member of the above-named partnership, S corporation,

LLC or LLP, request to be exempt from the Kansas income tax withholding required on my share of the Kansas taxable income of the

above-named partnership, S corporation, LLC or LLP for tax year ____________, and all subsequent years, until I notify the department

of a change in this election. By signing this affidavit, I agree to:

1) File a Kansas income tax return, and make timely payment of all Kansas income tax imposed by the laws of this state with respect

to my share of the Kansas taxable income of the above-named partnership, S corporation, LLC or LLP for every year in which I

maintain my exemption status.

2) Be subject to the “personal jurisdiction” of the Kansas Department of Revenue in courts of the state of Kansas for the purpose of

determining and collecting any Kansas taxes, including estimated taxes, together with any related interest and penalties, imposed

on me by the state of Kansas with respect to my share of the Kansas taxable income of the above-named partnership, S

corporation, LLC or LLP.

If I fail to abide by the terms of this affidavit, I understand that the department may revoke the exemption from withholding at any time.

PART C - WITHHOLDING TAX EXEMPTION REVOCATION

Nonresident Owner’s Name

Social Security Number (If not an individual, enter the EIN)

Street Address, City, State & Zip Code

I, ____________________________________, as a partner/shareholder/member of the above-named partnership, S corporation,

LLC or LLP, hereby revoke my previous withholding election dated _______________. At this time, I request to be subject to withholding

on my share of the Kansas taxable income of the above-named partnership, S corporation, LLC or LLP for tax year ____________, and

all subsequent years, until I notify the department of a change in this election.

PART D - SIGNATURE

(

)

Signature of Nonresident Owner

Date

Daytime Phone

(If not an individual, signature of officer or director.)

Partnerships, S corporations, LLCs and LLPs are required to

TAXPAYER ASSISTANCE

withhold Kansas income tax from a nonresident owner’s share

For assistance in completing this form, contact our office:

(whether distributed or undistributed) of Kansas taxable income

from the partnership, S corporation, LLC or LLP. The nonresident

Withholding Tax Section

owner withholding rate is 6.45% of the nonresident owner’s share

Kansas Department of Revenue

of Kansas taxable income.

Docking State Office Building, 1st Floor

A nonresident owner who elects to be subject to the personal

915 SW Harrison Street

jurisdiction of the department for the purpose of determining and

Topeka, KS 66625-0002

collecting any Kansas taxes may “opt-out” of this withholding

requirement by providing this completed affidavit to the pass-

Phone: (785) 368-8222

through entity. A copy of this affidavit must be submitted by the

Fax: (785) 296-2073

pass-through entity with Form KW-7S to show why withholding

Additional copies of this and other tax forms are available from

tax is not being paid on behalf of that nonresident owner. Part C

our office or web site:

of the affidavit is to be used only to revoke a prior election.

Form Kw-7a - Kansas Nonresident Owner Withholding Affidavit

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