2020
KANSAS HOMESTEAD CLAIM
K-40H
(Rev. 7-20)
DO NOT STAPLE
FILE THIS CLAIM AFTER DECEMBER 31, 2020, BUT NO LATER THAN APRIL 15, 2021
Claimant’s
Social Security
Number
First four letters of
claimant’s last name.
Use ALL CAPIT
AL letters.
Claimant’s
Telephone
Number
Your First Name Initial Last Name
Mailing Address (Number and Street, including Rural Route)
City, Town, or Post Oce State Zip Code County Abbreviation
Mark this box if claimant is
deceased (See instructions)
Date of Death
IMPORTANT: Mark this box if
name or address has changed
Mark this box if this is an
amended claim
TO QUALIFY YOU MUST HAVE BEEN A RESIDENT OF KANSAS THE ENTIRE YEAR OF 2020 AND OWN YOUR HOME.
Answer ONLY the questions that apply to you:
MONTH DAY YEAR
1. Age 55 or over for the entire year? Enter date of birth (must be prior to 1965)
2. Disabled or blind for the entire year? Enter the date
disability began. See instructions
ENCLOSE Social Security Benet
Verication Statement or Schedule DIS
3. Dependent child who resided with you and was under 18 years of age for the entire year?
Child’s name Enter date of birth (must be prior to 2020)
Mark this box if you are ling as surviving spouse of a disabled veteran OR of an active duty service
member who died in the line of duty (see instructions for this qualication and for required enclosures).
ENTER THE TOTAL RECEIVED IN 2020 FOR EACH TYPE OF INCOME. See instructions.
4. 2020 Wages OR Kansas Adjusted Gross Income (if negative, enter zero) $ plus Federal
Earned Income Credit $ Enter the total
5. All taxable income other than wages and pensions not included in Line 4. Do not subtract net operating losses
and capital losses
6. Total Social Security and SSI benefits, including Medicare deductions, received in 2020 (do not include
disability payments from Social Security or SSI) $ Enter 50% of this total
7. Railroad Retirement benets and all other pensions, annuities, and veterans benets (do not include
disability payments from Veterans and Railroad Retirement)
8. TAF payments, general assistance, worker’s compensation, grants and scholarships
9. All other income, including the income of others who resided with you at any time during 2020
10.
TOTAL HOUSEHOLD INCOME
(Add lines 4 through 9. If line 10 is more than $36,300 you do not qualify for a refund)
11. Percent of the homestead property that was rented or used for business in 2020 (see instructions)
12. 2020 general property taxes, excluding specials. (Tax on property valued at
more than $350,000 does not qualify. See instructions.)
Mark this box if you have
delinquent property tax.
13. Amount of property tax allowed. Enter amount from line 12 or $700, whichever is less
14. Using your total household income on line 10 and the Refund Percentage Table, enter your refund percentage
15. HOMESTEAD REFUND (Multiply line 13 by percentage on line 14)
Important:
If you led Form ELG with your county, your refund will be reduced by the ELG amount applied to the rst half of your 2020 property tax.
Mark this box if you wish to participate in the Refund Advancement Program (see instructions)
I authorize the Director of Taxation or the Director’s designee to discuss my K-40H and 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 claim.
Claimant’s signature Date Signature of preparer other than claimant Preparer’s phone number
COMPLETE THE BACK OF THIS FORM
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134120
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Qualications
Household Income
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Name and Address
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Refund
%
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%
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Signature
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