Form K-40v - Kansas Individual Income Tax Payment Voucher - 2015
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1FORM K-40V INSTRUCTIONS
Print your name, address, Social Security number, and the first
If you are filing an extension of time to file your return, mark the
four letters of your last name in the spaces provided. If you are
appropriate box with “X”. Note that an extension of time is an
filing a joint return, print that same information for your spouse
extension to file, NOT an extension to pay.
in the spaces provided. If your name or address information has
Do not attach the payment voucher or payment to your
changed since last year, be sure to mark the “Name or Address
return or to each other. Place them loosely in the envelope
Change” box with “X”.
with your return. If you have already mailed your return, or
you filed electronically and didn’t pay electronically, mail your
Make your check or money order payable to “Kansas Income
payment and the voucher to:
Tax” for the full amount of your tax due. Be sure the last 4
digits of your Social Security number (example: XXXXX1234)
KANSAS INCOME TAX
are printed on your check or money order. If payment is not
KANSAS DEPARTMENT OF REVENUE
made on or before April 15, 2016, the tax due is subject to
915 SW HARRISON ST
penalty and interest.
TOPEKA KS 66612-1588
NOTE: If any due date falls on a Saturday, Sunday, or legal holiday, substitute the next regular work day.
K-40V
2015 KANSAS
FOR OFFICE USE ONLY
Please use UPPER CASE letters
INDIVIDUAL INCOME TAX
to print the first four letters of
Rev. 7-15
PAYMENT VOUCHER
Spouse’s last name
Your last name
Your First Name
Initial
Last Name
Your Social
Spouse’s First Name
Initial
Last Name
Security number
Spouse’s Social
Security number
Mailing Address (Number and Street, including Rural Route)
Name or
Address
Change
City, Town, or Post Office
State
Zip Code
Write last 4 digits of your Social Security number on check or
money order and make payable to Kansas Income Tax.
Daytime Phone Number
Amended
Extension
Payment
$
Payment
Payment
Amoun
t
DO NOT SUBMIT PHOTOCOPIES OF THIS FORM
112015
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