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    2011 Income Tax Return

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    salazar17
    Dora M. Mora filed a 2011 Kansas income tax return and homestead claim. She reported $980 in wages as her only income and claimed standard deductions and exemptions for herself and three dependents. Mora qualified for a homestead property tax refund and signed both forms, authorizing her preparer to discuss her returns. The documents provide details of her income, property taxes paid, and household members to determine her refund amount.

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    2011 Income Tax Return

    Uploaded by

    salazar17
    58 views4 pages
    Dora M. Mora filed a 2011 Kansas income tax return and homestead claim. She reported $980 in wages as her only income and claimed standard deductions and exemptions for herself and three dependents. Mora qualified for a homestead property tax refund and signed both forms, authorizing her preparer to discuss her returns. The documents provide details of her income, property taxes paid, and household members to determine her refund amount.

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    STF1327176264026

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    Dora M. Mora filed a 2011 Kansas income tax return and homestead claim. She reported $980 in wages as her only income and claimed standard deductions and exemptions for herself and three dependents. Mora qualified for a homestead property tax refund and signed both forms, authorizing her preparer to discuss her returns. The documents provide details of her income, property taxes paid, and household members to determine her refund amount.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    58 views4 pages

    2011 Income Tax Return

    Uploaded by

    salazar17
    Dora M. Mora filed a 2011 Kansas income tax return and homestead claim. She reported $980 in wages as her only income and claimed standard deductions and exemptions for herself and three dependents. Mora qualified for a homestead property tax refund and signed both forms, authorizing her preparer to discuss her returns. The documents provide details of her income, property taxes paid, and household members to determine her refund amount.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4

    2011 Income Tax Return

    Kansas Return
    Thank you for using FreeTaxUSA.com to prepare your 2011 income tax return.

    You can view the status of your e-filed tax return by logging into your account at www.freetaxusa.com. 2012 tax preparation on FreeTaxUSA.com will be available starting in January of 2013. We look forward to preparing your 2012 tax return.

    K-40 2011
    DORA L MORA 720 S EDGEMOOR WICHITA X
    Amended Return:

    KANSAS INDIVIDUAL INCOME TAX FOOD SALES TAX REFUND

    006

    122811

    3162145839 KS 67218 WH 259

    MORA

    931774471

    Filing Status:

    Residency Status:

    Exemptions:

    Single

    4 1 5

    List below dependent name(s), date of birth, relationship, and SSN of persons claimed. Enclose additional sheets if needed.

    KS 05261992 08201931 07171999 DAUGHTER PARENT NIECE 931774467 981701467 926864374

    MARTHA A ROSAS DELIA ROQUE VALERIA GUTIERREZ

    Food Sales Tax Qualification: If you were a Kansas resident for all 2011, complete lines A through E to determine if you qualify for a Food Sales Tax refund.

    A.

    D.

    B. E.

    C.

    FOOD SALES TAX REFUND.

    IMPORTANT:

    K-40 2011
    (Rev. 6/11) Page 2

    KANSAS INDIVIDUAL INCOME TAX and/or FOOD SALES TAX REFUND 931774471 -10798 0 -10798 4500 11250 15750 0 0
    21. Estimated tax paid

    006

    122911

    DORA L MORA
    1. Federal adjusted gross income

    0 0 0 0

    2. Modifications

    22. Amount paid with KS extension

    3. Kansas adjusted gross income

    23. Earned income credit

    4. Standard or itemized deductions

    24. Refundable portion of tax credits

    5. Exemption allowance

    25. Payments remitted w/ original return

    6. Total deductions

    26. Overpayment from original return 27. Total refundable credits and if applicable your Food Sales Tax refund.

    7. Taxable income

    8. Tax

    28. Underpayment

    9. Nonresident percentage

    29. Interest

    10. Nonresident tax

    30. Penalty

    11. KS tax on lump sum distributions

    31. Estimated tax penalty

    12. TOTAL INCOME TAX

    0 0 0 0 0 0 0 0 0

    32. AMOUNT YOU OWE

    0 0 0 0 0 0 0 0

    13. Credit for taxes paid to other states

    33. Overpayment

    14. Credit for child & dependent care exp.

    34. CREDIT FORWARD

    15. Other credits

    35. Chickadee Checkoff

    16. Total tax credits

    36. Senior Citizens Meals On Wheels Contribution Program 37. Breast Cancer Research Fund

    17. Income tax balance after credits

    18. Use Tax Due

    38. Military Emergency Relief Fund

    19. Total Tax Balance 20. KS income tax withheld from W-2, 1099 or K-19

    39. REFUND

    I authorize the Director of Taxation or the Director's designee to discuss my K-40 and any enclosures with my preparer. I declare under the penalties of perjury that to the best of my knowledge and belief this is a true, correct, and complete return.
    Taxpayer Signature (Required) Spouse Signature (Required) Preparer Date Signature

    Preparer PTIN, EIN, or SSN

    Preparer Date Phone Number

    K-40H
    (Rev. 6/11)

    2011

    KANSAS HOMESTEAD CLAIM


    MORA WH X
    Name or address has changed?

    006

    135011 931774471 3162145839


    Filing an amended claim

    DORA L MORA 720 S EDGEMOOR WICHITA KS 67218


    Claimant died during 2011 --- Date of death

    1. Age 55 or over for the entire year. Enter date of birth

    7. Railroad Retirement benefits & all other pensions, annuities, & veterans benefits (do not include disability payments from Veterans and Railroad Retirement) 8. TAF payments, general assistance, worker's compensation, grants and scholarships

    2. Disabled or blind for the entire year. Enter date disability began. 3. Enter date of birth of dependent Child's name __________________ _____________________________________

    VALERIA GUTIERREZ

    07171999

    9. All other income, including income of others who resided with you at any time during 2011 10. TOTAL HOUSEHOLD INCOME

    Check if filing as surviving spouse of a disabled veteran OR an active duty service member who died in the line of duty. 4a. 2011 Wages OR KAGI $

    11. OWNER - 2011 general property taxes

    980

    4b. Federal Earned Income Credit.

    Check if you have delinquent property taxes.

    4c. Enter the total. Add lines 4a and 4b. 5. All taxable income other than wages/pensions not included in Line 4. Do not subtract net operating/capital losses. 6. Total SS & SSI benefits incl. Medicare deductions, received in 2011 (do not include disability payments from SS or SSI). $______________ Enter 50% of this total.

    12. RENTER

    13. Total

    700 100 700

    14. Enter your refund percentage

    15. Homestead refund

    NOTE: If you filed Form K-40PT for 2011, you DO NOT qualify for this refund.
    (a) Food stamps (d) Settlements (g) Other: Source

    IMPORTANT: If you filed Form ELG with your county, your refund will be reduced by the ELG amount applied to the first half of your 2011 property tax.
    (c) Child support (f) SSI, Social Security, Verterans or Railroad Disability Amount

    Excluded Income - Providing the information should speed up the processing of your claim. Enter the annual amount of all other income not included as income on line 10. (b) Nongovernmental Gifts (e) Personal and Student Loans

    Owner Statement - Is the property listed above owned by someone other than you OR you and your spouse? No

    Yes No

    If yes, did that person reside with you in 2011? No Yes %

    Yes

    If the property was owned by someone other than you OR you and your spouse, did they pay any portion of the property tax? did they pay? What portion, if any, of the homestead property was rented or used for business in 2011?

    If yes, what amount of the total property tax due

    Members of Household - Name, Date of birth (MMDDYYYY), Relationship, Months in home, Income included on lines 4-9 (Y OR N), SSN. Enclose additional sheets if needed.

    DORA MORA MARTHA ROSAS VALERIA GUTIERREZ DELIA ROQUE

    10291960 05261992 07171999 08201931

    MOTHER DAUGHTER NIECE PARENT

    12 12 06 12

    N N N N

    931774471 931774467 926864374 981701467

    Check this field if you wish to participate in the Refund Advancement Program.

    I authorize the Director of Taxation or the Director's designee to discuss my K-40H and enclosure with my preparer. I declare under the penalties of perjury that to the best of my knowledge and belief this is a true, correct, and complete return. IMPORTANT: Please allow 20 to 24 weeks to process your refund. Renters should allow 28 weeks so the rent can be verified with your landlord.
    Preparer Date Phone Number

    Claimant's Signature Date

    Preparer Signature

    HOMESTEAD CLAIM 915 SW HARRISON ST TOPEKA KS 66699-2000

    F o r

    O f f i c e

    U s e

    O n l y

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