110718
                                                            KANSAS
KS-2848(Rev. 11-19)               SERVICEMEMBER MOBILIZATION NOTICE

In recognition of the Servicemember’s Civil Relief Act (SCRA), the following information will be used by the Kansas 
Department of Revenue, Division of Taxation, to the service member’s eligibility for tax deferments during the time the 
servicemember is mobilized. To determine if you should complete and submit this form, see the instructions.
This notice must be completed in its entirety and all required documents enclosed (see instructions). Please type or 
print all information clearly.

SERVICEMEMBER INFORMATION 

Name ___________________________________________________________________________________________  Social Security No. _________ - _______  - _________
                        (Last name, first name, middle initial)

Physical Address ____________________________________________________________________________________________________________________________________________
City ____________________________________________________________________________________________ State_______ Zip Code ___________________________
PO Box _________________________  City___________________________________________________         State_______ Zip Code_____________________________

Marital Status (check one): Married o      Single o

Mark this box if you are seeking protection from an existing tax debt with the Kansas Department of Revenue:            o

MILITARY INFORMATION                                                                              You  must  enclose  a  copy  of  your
                                                                                                  orders  pursuant  to  Federal  Title  10, 
Military Order No. _____________________________________________________________________________  USC SUBSEC 502 (A) (AT) Orders.

Period of duty covered in original orders, including contingent period (TDY):
From__________/________/_________ to  __________/_________ __________/
       (Month, Day, Year)                  (Month, Day, Year)

SPOUSE INFORMATION

Name ___________________________________________________________________________________________  Social Security No. _________ - _______  - _________
                        (Last name, first name, middle initial)
Physical Address (if different from above) _______________________________________________________________________________________________________________
City ____________________________________________________________________________________________ State_______ Zip Code ___________________________
PO Box _________________________  City___________________________________________________         State_______ Zip Code_____________________________

       By marking this box, I am authorizing the Director of Taxation or the Director’s designee to discuss my tax account information 
       with my Power of Attorney. My Power of Attorney is: ________________________________________

SIGN   I certify that the information provided on this form is true, correct, and complete.
HERE   ______________________________________________________________________________________                  ________________________________________
                                  (Servicemember’s Signature)                                                           (Date)

                   Copies of your deployment orders must be enclosed with Form KS-2848.
       Also enclose any assessment or set-up return notices you may have received from KDOR.

                    SERVICEMEMBER CIVIL RELIEF ACT (SCRA)

How does the        KDOR  (Kansas  Department  of  Revenue)  follows  the  IRS  in  automatically  extending 
SCRA help me?       income  tax  deadlines,  for  180  days  after  deactivation,  for  filing  returns,  paying  taxes,  filing 
                    claims for refunds, and taking other actions with KDOR if any of the following situations apply:
                    • You  serve  in  the  Armed  Forces  in  a  combat  zone  or  you  have  qualifying  service
                      outside of a combat zone.
                    • You serve in the Armed Forces in a qualified hazardous duty area or are deployed
                      overseas away from your permanent duty station in support of operations in a qualified
                      hazardous duty area, but your deployment station is outside the qualified hazardous duty
                      area.
                    • You  serve  in  the  Armed  Forces  on  deployment  outside  the  United  States  away
                      from your permanent duty station while participating in a contingency operation. A
                      contingency operation is a military operation that is designated by the Secretary of
                      Defense or results in calling members of the uniformed services to active duty (or
                      retains them on active duty) during a war or a national emergency declared by the
                      President or Congress.

                    By extending tax deadlines, KDOR hopes to provide servicemembers with a smooth and 
                    convenient transition before, during, and after deployment.

Who should          If you qualify for deferment of taxes based on the criteria above and find yourself in one or 
complete and        more  of  the  following  situations,  then  you  should  complete  Form  KS-2848,  Servicemember 
                    Mobilization Notice, and submit it to KDOR:
submit the SCRA
form?               • You cannot file your income tax return and pay any tax due until you return from
                      deployment.
                    • You have an existing debt with KDOR for taxes due and are unable to pay while you are
                      deployed.
                    • You have received an assessment or a set-up return notice from KDOR and will not be
                      able to file your return and/or pay the tax due until you return from deployment.
                    For  your  convenience,  Form  KS-2848  is  available  as  a  “fill-in”  form.  Simply  type 
                    the required  information  in  the  blank  fields,  print  the  form,  sign  it,  and  mail  it  to  KDOR.  The 
                    “fill-in” form is available at this website address: ksrevenue.org/scra.html

Where do I send     Send your completed Form KS-2848, along with a copy of your deployment orders and any 
Form KS-2848        KDOR assessment or set-up return notices you may have received, to the following address: 
and enclosures?                             Kansas Department of Revenue
                                               PO Box 750260
                                               Topeka KS 66699-0260

What must I do if I You must continue to file sales and withholding returns and remit any tax due unless you 
have a business?    are  a sole proprietor with no sales tax or withholding obligations. If your business continues to 
                    operate  while  you  are  deployed  and  you  have  employee(s)  obligations,  you  should  seek 
                    additional advice from your accountant or CPA.

What should I do    When you return you should file the appropriate tax documents and/or pay the balance due 
when I return to    to bring your account up-to-date. You may contact KDOR and a Customer Representative will 
normal duty?        assist you with that process. Taxpayer assistance information can be found on the back cover of 
                    this publication.