Form K-40 - Kansas Individual Income Tax Return - 2015
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1
22015
K-40
KANSAS INDIVIDUAL INCOME TAX
114515
(Rev. 7/15)
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 last name.
Use ALL CAPITAL letters.
City, Town, or Post Office
State
Zip Code
County Abbreviation
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 2015 Kansas return mark one of the following boxes:
Return
(Mark ONE)
Amended affects Kansas only
Amended Federal tax return
Adjustment by the IRS
Filing Status
Married filing joint
Head of household (Do not
Married filing separate
(Mark ONE)
Single
mark if filing a joint return)
(Even if only one had income)
Residency
Status
Part-year resident from _____________ to _____________
Nonresident
Resident
(Complete Sch. S, Part B)
(Complete Sch. S, Part B)
(Mark ONE)
Exemptions
Enter the number of exemptions you claimed on your 2015 federal return. If no federal return is required,
and
enter total exemptions for you, your spouse (if applicable), and each person you claim as a dependent.
Dependents
If filing status above is Head of household, add one exemption.
Total Kansas exemptions.
Enter the requested information for all persons claimed as dependents. Do NOT include you or your spouse. Enclose separate schedule if necessary.
Name (please print)
Date of Birth (MMDDYY)
Relationship
Social Security Number
Food Sales
You must have been a Kansas resident for ALL of 2015. Complete this section to determine your qualifications and credit.
Tax Credit
{
A. Had a dependent child who lived with you all year and was under the age of 18 all of 2015? .............. YES
NO
Mark
B. Were you (or spouse) 55 years of age or older all of 2015 (born before January 1, 1960)? .................. YES
ONE
NO
box
C. Were you (or spouse) totally and permanently disabled or blind all of 2015, regardless of age? .......... YES
NO
If you answered NO to A, B, and C, STOP HERE; you do not qualify for this credit.
00
D. If you answered YES to A, B, or C, enter your federal adjusted gross income from line 1 of
this return. If it is more than $30,615, STOP HERE; you do not qualify for this credit.
E. Number of exemptions claimed on your federal income tax return ........................................................
F. Number of dependents that are 18 years of age or older (born before January 1, 1998) ......................
G. Total qualifying exemptions (subtract line F from line E) ........................................................................
00
H. Food Sales Tax Credit (multiply line G by $125). Enter the result here and on line 17 of this form.
Mail to: Kansas Income Tax, Kansas Dept. of Revenue
915 SW Harrison St., Topeka, KS 66612-1588
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