Form K-40 - Kansas Individual Income Tax - 2013

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K-40

2013

114513

KANSAS INDIVIDUAL INCOME TAX

(Rev. 8/13)

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

If your name or address has changed since last year, mark an "X" in this box

Daytime

telephone

If taxpayer (or spouse if filing joint) died during this tax year, mark an "X" in this box

number

Amended

If this is an AMENDED 2013 Kansas return mark one of the following boxes:

Return

Amended affects Kansas only

Amended Federal tax return

Adjustment by the IRS

(Mark ONE)

Filing Status

Married filing joint

Head of household (Do not

Single

Married filing separate

(Mark ONE)

(Even if only one had income)

mark if filing a joint return)

Residency

Part-year resident from ___ ___ ___

to ___ ___ ___

Nonresident

Status

Resident

(Complete Sch. S, Part B)

(Mark ONE)

Exemptions

Enter the number of exemptions you claimed on your 2013 federal return. If no federal return is required, enter total

exemptions for you, your spouse (if applicable), and each person you claim as a dependent.

and

Dependents

If filing status above is Head of household , add one exemption.

Total Kansas exemptions.

In the following spaces, provide the requested information for all persons you claimed as dependents. Do NOT include you or your spouse. If additional

space is needed, enclose a separate schedule.

Name (please print)

Date of Birth (mm/dd/yy)

Relationship

SSN (Social Security Number)

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