Form K-19 Report of Nonresident Owner Tax Withheld

% of Ownership in Part B Entity (1) Percent of Ownership in Part A Entity (2) Nonresident Owner s Share of Kansas Taxable Income (3) Total Kansas Tax Withheld (Rev 9/12) 915 SW Harrison 1st Floor City State Zip Code Employer Identification Number (EIN) Fax: (785) 291 3614 GENERAL INSTRUCTIONS HOW TO COMPLETE FORM K 19 If the business structure of the taxpayer shown in Part B is other than an individual or a C corporation the Part B entity will complete Part D to report each owner s share of the income and withholding reported in Part C to each of its partners shareholders or members If the partner listed in Part D is itself a pass through entity the Part D entity must enclose a separate schedule showing the information below for each partner shareholder or member of the Part D entity If you have questions about withholding tax or completing this form please contact the Kansas Department of Revenue: Important Beginning in tax year 2013 income that is properly reported on federal Schedule C E or F and lines 12 17 or 18 of federal Form 1040 is not subject to Kansas income tax; therefore not subject to Kansas withholding Nonresident owners receiving taxable income that is not properly reported on the applicable federal forms/lines (i e taxable income) will be subject to Kansas nonresident owners withholding Individual Partnership S Corporation K 19 2012 K S A 79 32 100e requires withholding on Kansas taxable income (whether distributed or undistributed) of a nonresident partner member or shareholder of a partnership S corporation or LLC or LLP A nonresident owner may be an individual a corporation or a pass through entity The withholding rate is 6 45% of the Kansas taxable income and is due on or before the due date of the income tax return of the pass through entity including extensions If you have nonresident owners you must also complete a Schedule of Nonresident Owner Withholding (KW 7S) and a Nonresident Owner Withholding Return (KW 7) to remit the tax withheld LLC LLP Trust Name of Partnership S Corporation LLC or LLP Name Street Address City State Zip CodeSocial Security Number or EIN of Owner NONRESIDENT OWNER OPTIONS: Nonresident owners may opt out of the required Kansas income tax withholding on their share of the Kansas taxable income by filing an affidavit Form KW 7A with the pass through entity and reported on the entity s Form KW 7S Certain nonresident owners may be eligible and elect to use the Kansas tax withheld reported on Form KW 7S in lieu of filing Form K 40 or Form K 40C Refer to the instructions for Forms KW 7/KW 7S for details on these two options Other (specify) Partner/Shareholder/Member Name SSN or EIN Partnership S Corporation LLC LLP Phone: (785) 368 8222 Prepare three copies of Form K 19 for each nonresident owner for whom Kansas tax was withheld and paid with Forms KW 7 and KW 7S and distribute as follows: REPORT OF NONRESIDENT OWNER TAX WITHHELD Share of Kansas Taxable Income Share of Kansas Tax Withheld Street Address Tax year ending date of Partnership S Corporation LLC or LLP TAXPAYER ASSISTANCE Taxpayer Assistance Center The Kansas Withholding Tax publication (KW 100) contains more information about nonresident owner withholding Kansas forms and publications are available from our web site at ksrevenue org or by calling our Taxpayer Assistance Center The pass through entity will complete Parts A B and C If the nonresident owner in Part B is itself a pass through entity the Part B entity will use Part D to report the ownership percentage and share of the amounts shown in Part C for each of its partners shareholders or members Those Part B entities who are completing Part D will in turn prepare three copies of Form K 19 to be distributed as follows: to be retained by pass through entity for its records to be retained by the partnership S corporation LLC or LLP for its records to each of your owners for their records to each of your owners to enclose with their Kansas income tax return to your nonresident distributees for their records to your nonresident owners to enclose with their Kansas income tax return Topeka KS 66625 2007 Type of Ownership: Type of Taxpayer: