Form K-41 Fiduciary Income Tax

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Nonresident(Seeinstructions) Residency Status (Mark ONE) Resident to be retained by fiduciary to the beneficiary for their records to the beneficiary from whom the tax is withheld to enclose with their Kansas Income Tax return (A) (B) (C) (D) (A) Theseitemscorrespondtothoselistedon FederalForm1041 (B) Totalincomeas reportedonFederal Form1041 (C) Amountfrom Kansassources (D) Nonresidentfiduciary's portionofCol C&capital gainsnotdistributed (A)Nameand Address (B) SocialSecurity Number (C) Beneficiary's percentage (D)Kansas taxableincome (E)Taxtobewithheld (MultiplyCol Dby2 5%) (i) Ch (j) Fid (Rev 7/12) 10 00 11 00 12 00 13 00 14 00 140012 140112 15 00 16 00 17 00 18 00 19 00 20 00 20 12 21 00 22 00 23 00 24 00 24 REFUND(Ifline19isgreaterthanline12) 25 Additionstofederaltaxableincome: 25a 00 25b 00 25c 00 25d 00 25e 00 26 Subtractionsfromfederaltaxableincome: 26a 00 26b 00 26c 00 26d 00 26e 00 27 00 27 Netmodificationtofederaltaxableincome(Subtractline26efromline25e) 28 29 30 31 32 33 34 35 36 Interestincome Dividends Businessincome(loss) Capitalgain(loss) Rents royalties partnerships otherestatesandtrusts etc Farmincome(loss) Ordinaryincome(loss) Otherincome Total income(Addlines28through35) AdministrativeexpensesclaimedasdeductionsonKansasestatetaxreturn Amended filers: Overpaymentfromoriginalreturn(Thisfigureisasubtraction;seeinstructions) Amended filers: Paymentsremittedwithoriginalreturn AmountpaidwithKansasextension aritablebeneficiaries'portion (i) Subtotal uciary'sportion (j) Total % % % % % % % 100% Balance(Subtractline11fromline7;cannotbelessthanzero) BALANCEDUE(Addlines20 21and22) andmakepayableto: KansasFiduciaryTax BankruptcyEstate MONTH DAY YEAR CITY STATE ZIP CODE City Town orPostOffice State Creditfortaxespaidtootherstates(Residentestatesortrustsonly;Seeinstructions) Date Established Dateofdecedent'sdeathordatetrustestablished: Distribute copies of Form K 18 as follows: DO NOT STAPLE ENDING DATE OF ESTATE OR TRUSTS TAX YEAR Estate Exemptretirementbenefits Federaltaxableincome (Residents:FederalForm1041;Nonresidents:PartIII line49 columnD) FIDUCIARY INCOME TAX Filing Status (Mark ONE) FOR NONRESIDENT ESTATES AND TRUSTS OR RESIDENT ESTATES AND TRUSTS For the taxable year beginning / / ; ending / / I declare under the penalties of perjury that to the best of my knowledge and belief this is a true correct and complete return IauthorizetheDirectorofTaxationortheDirector'sdesigneetodiscussmyK 41andenclosureswithmypreparer Ifyournameoraddresschangedsincelastyear markan"X"inthisbox Interest Taxes Fiduciaryfees Charitablededuction Attorney accountant andreturnpreparerfees Otherdeductionsnotsubjecttothe2%floor Allowablemiscellaneousitemizeddeductionssubjecttothe2%floor Total (Addlines37through42b) 37 38 39 40 41 42a 42b 43 INTEREST(Seeinstructions) InterestonU S Governmentobligations(Reducedbyrelatedexpenses encloseschedule) K 18 2012 FIDUCIARY REPORT OF NONRESIDENT BENEFICIARY TAX WITHHELD KANSAS DEPARTMENT OF REVENUE K 41 2012 KANSAS Kansasincometaxwithheld(EncloseK 19forms seeinstructions) Kansastaxableincome(Line1plusorminusline2 Seeinstructions) Kansastaxonlumpsumdistributions(Seeinstructions) MAIL TO: Fiduciary Tax Kansas Department of Revenue 915 SW Harrison St Topeka KS 66699 3000 MailingAddress(NumberandStreet includingRuralRoute) NameandAddress SocialSecurityNo Distribution PartI multipliedbycolumnC) NONRESIDENT BENEFICIARY'S NAME SOCIAL SECURITY NO NAME OF ESTATE OR TRUST NONRESIDENTBENEFICIARIES Nonresidentbeneficiarytax(PartIVtotalofcolumnE) NOTE: If the "TOTAL" line in Part IV Column E is zero and line 23 is zero DO NOT FILE this return (Both entries must be zero ) NOTE: The Kansas fiduciary modification is to be allocated among the beneficiaries and the fiduciary in proportion to their share of the sumof the federal distributable net income and the amount distributed or required to be distributed from current income Otheradditions(Seeinstructions encloseschedule) Othernonrefundablecredits(Encloseallappropriateschedules) Othersubtractionsfromfederaltaxableincome(Seeinstructions encloseschedule) Over But Not Over $ 0 $15 000 3 50% of line 3 $15 000 $30 000 $ 525 00 plus 6 25% of excess over $15 000 $30 000 $1 462 50 plus 6 45% of excess over $30 000 If amount on line 3 Form K 41 is: Enter on line 4 Form K 41: PART I MODIFICATIONS TO FEDERAL TAXABLE INCOME PART II COMPUTATION OF SHARES OF THE MODIFICATION TO FEDERAL TAXABLE INCOME PART III COMPUTATION OF FEDERAL TAXABLE INCOME OF THE ESTATE OR TRUST FROM KANSAS SOURCES PART IV NONRESIDENT BENEFICIARIES' SHARES OF INCOME AND TAX TO BE WITHHELD PENALTY(Seeinstructions) WriteyourEINonyourcheckormoneyorder Percentof Shareoffiduciaryadjustment(line27 PLEASE COMPLETE THE BACK OF THIS FORM Refundableportionofcredits(Encloseallappropriateschedules) RESIDENTBENEFICIARIES Residentfiduciary'sshareofmodificationstofederaltaxableincome(residents only) PartI line27orPartII line(j) Signatureofpreparerotherthanfiduciary Address/TelephoneNumber Date signhere Signatureoffiduciary Title Date Stateandlocalbondinterest(Reducedbyrelatedexpenses encloseschedule) Stateincometaxrefundsreportedasincomeonfederalreturn Stateorlocaltaxesmeasuredbyincomedeductedonthefederalreturn STREET ADDRESS OR RURAL ROUTE * * Beneficiary: Enter this amount on the "Kansas Income Tax Withheld" line of your Kansas Individual Income Tax return (K 40) NONRESIDENT BENEFICIARY'S SHARE OF DISTRIBUTABLE INCOME FROM KANSAS SOURCES: Taxable income $ Modifications as if Kansas resident $ Amount of tax withheld $ Subtractline43fromline36 Distributionstobeneficiaries Estatetaxdeduction(fiduciary) Estatetaxdeduction(beneficiary) Exemption (ForColumnD seeinstructions) Total (Addlines45through47) 44 45 46 47 48 Tax (Fromtaxcomputationscheduleonthelastpageofthisform) TAX COMPUTATION SCHEDULE TAX WITHHELD FOR NONRESIDENT BENEFICIARIES Taxableincome(Subtractline48fromline44) Totalpercentofallnonresidentbeneficiaries fromPartII lines(e) (f) (g)&(h) TotalKansasincomeofnonresidentbeneficiaries(Multiplyline49byline50) 49 50 51 Technicalandcommunitycollegedeferredmaintenancecreditrefund(seeinstructions) TOTAL Enter amount from column E on line 6 TOTAL KANSAS TAX (Addlines4 5 and6) Totaladditionstofederalincome(Addlines25athrough25d) Totalcredits(Addlines8 9and10) Totalrefundablecredits(Addlines13through17andsubtractline18) Totalsubtractionsfromfederaltaxableincome(Addlines26athrough26d) Trust Under Kansas law the executor administrator trustee or other fiduciary of an estate or trust is required to withhold 2 5% ( 025) of the amount distributable to each nonresident beneficiary The amount to be withheld from each nonresident beneficiary is shown in Part IV column (E) For each nonresident beneficiary from whom tax is withheld three copies of the "Fiduciary Report of Nonresident Beneficiary Tax Withheld " Form K 18 must be prepared Copy the Form K 18 shown below or download from our web site at ksrevenue org UNDERPAYMENT(Ifline12isgreaterthanline19) Universitydeferredmaintenancecredit(Seeinstructions) WITH NONRESIDENT BENEFICIARIES

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