Form K-40h - Kansas Homestead Claim - 2007 Page 2
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Providing the information in this section may speed up the processing of your claim.
(This income should not be included on line 10, page 1.)
Enter, in the spaces provided, the annual amount of all other income not included as household income on page 1, line 10.
Personal and
Settlements (lump
$
Food Stamps
$
$
Student Loans
sum)
SSI, Social Security,
Nongovernmental
Veterans, or Railroad
$ $
Child Support
$
$
Disability (enclose
Gifts
documentation)
Source
Amount
Other (See instructions on page 17)
$
I, ____________________________________________ resided at _____________________________________________ during 2007 and have paid or
(property address description)
will pay 100% of the taxes. If you have delinquent property taxes, mark the box on line 11, front of this form.
If the property listed above was owned by someone other than you or you and your spouse, did that person reside with you in 2007, and/or pay any part of
the taxes?
Yes
No
Explain:
What, if any, portion of the homestead property was rented or used for business in 2007? ________%
(See instructions on page 18.)
Complete the information below for ALL persons (including yourself) who resided in your household at any time during 2007. Indicate the number of
months they lived with you and whether or not their income is included on lines 4 through 9 of Form K-40H.
Income
Number of
included on
lines 4-9,
Name
Date of birth
Relationship
months resided
Social Security Number
-
- -
in household
Yes/No
Claimant:
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