PDF document
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2021

Homestead  or

Property Tax 

Refund for 

Homeowners

For a fast refund, 

file electronically! 

See back cover for details.

ksrevenue.gov



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                                              GENERAL INFORMATION

                          The 
Filing a Claim                Homestead claim (K-40H) allows a rebate of a portion of the property taxes paid on a Kansas resident’s 
                          homestead. A homestead is the house, mobile or manufactured home, or other dwelling subject to property tax 
                          that you own and occupy as a residence. Your refund percentage is based on your total household income and the 
Homestead refunds         refund is a percentage of your general property tax. The maximum refund is $700.
are  not  available  to   The Property Tax Relief claim (K-40PT) allows a refund of property tax for low income senior citizens that own 
renters. You must own     their home. The refund is 75% of the property taxes actually and timely paid on real or personal property used as 
your home to qualify.
                          their principal residence. Claimants that receive this refund cannot claim a Homestead refund.
                          The large purple boxes on Form K-40H and K-40PT allow us to process your refund claim faster and with fewer 
                          errors. Please follow these important instructions when completing your form:
                          • Use only black or dark blue ink.
                          •  Do not use dollar signs, lines, dashes, or other symbols. If a line does not apply to you, leave it blank.
                          • All entries must be rounded. If less than $.50 cents, round down. Round $.50 to $.99 to next higher dollar.
                          •  Send the original claim form. Do not send a photocopy.
                          •  If you are using an approved computer software program to prepare your claim, send the original form printed from your 
                            printer. Do not send a photocopy.

Qualifications            A homestead claim (K-40H) is for homeowners who own and occupy their homestead and were residents of 
                          Kansas all of 2021. This refund program is not available to renters. As an owner your name is on the deed for 
                          the homestead. As a resident the entire year and a homeowner, you are eligible if your total household income is 
                          $36,600 or less and you: 1) were born before January 1, 1966, or 2) were blind or totally and permanently disabled 
                          all of 2021, or 3) have a dependent child who lived with you the entire year who was born before January 1, 2021, 
A person owning a         and was under the age of 18 all of 2021.
homestead  with  an 
appraised valuation for   The property tax relief claim (K-40PT) is for homeowners that were 65 years of age or older, with a household 
property tax purposes     income of $20,900 or less, and a resident of Kansas all of 2021.
that exceeds $350,000     Only one refund claim (K-40H or K-40PT) may be filed for each household. A married couple OR two or more 
does NOT qualify for a    individuals who together occupy the same household may only file one claim. A married couple who own and occupy 
homestead refund.
                          separate households may file separate claims and include only their individual income.
                          If you owe any delinquent property taxes on your home your homestead refund will be used to pay those delinquent 
                          taxes. The Kansas Department of Revenue will send your entire refund to the County Treasurer.
                          If you moved during 2021, you may claim the general property tax paid for the period of time you lived in each 
                          residence. Homeowners who rent out part of their homestead or use a portion of it for business may claim only the 
                          general property tax paid for the part in which they live.

Definition of             A household is you, or you and your spouse who occupy a homestead, or you and one or more individuals 
                          not related through marriage who together occupy a homestead. Household income is generally all taxable and 
a Household 
                          nontaxable income received by all household members during 2021. If a household member lived with you only part 
and Household             of the year, you must include the income they received during the months they lived with you.
Income
                          Household income includes, but is not limited to:
                          •  Taxable and nontaxable wages, salaries, and self-employment income.
                          •  Federal earned income tax credit (EITC).
                          •  Taxable and nontaxable interest and dividends.
                          • Social Security and SSI benefits. The amount included depends on which refund claim you file:
                              K-40H – 50% of Social Security and SSI benefits (except disability payments – see Excluded Income).
                              K-40PT – 100% of Social Security and SSI benefits (except disability payments – see Excluded Income).
                          • Railroad Retirement benefits (except disability payments).
                          • Veterans’ benefits and all other pensions and annuities (except disability payments).
                          •  Welfare and Temporary Assistance to Family (TAF) payments.
                          •  Unemployment, worker’s compensation and disability income.
Net operating loses and   •  Alimony received.
net capital losses cannot •  Business and farm income.
be used to reduce total   •  Gain from business or investment property sales and any long-term capital gains included in federal adjusted gross income.
household  income.  DO 
NOT subtract these        • Net rents and partnerships (cannot be a negative figure).
losses from the income    •  Foster home care payments, senior companion stipends, and foster grandparent payments.
amounts.                  •  School grants and scholarships (unless paid directly to the school).
                          •  Gambling winnings, jury duty payments, and other miscellaneous income.
                          •  ALL OTHER INCOME received in 2021 not specifically excluded (as follows).
                          Excluded Income — DO NOT include these items as household income:
                          •  50% of Social Security and SSI payments. This exclusion applies only to the Form K-40H, Homestead Claim. K-40PT filers 
                            will report 100% of Social Security and SSI payments.
                          •  Social Security disability payments.
                          •  Social Security and SSI payments that were Social Security “disability or SSI disability” payments prior to a recipient 
                            reaching full retirement age. These Social Security payments, that were once Social Security disability (or SSI disability) 
                            payments, are NOT included in household income.

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When and                  File your claim after December 31, 2021 but no later than April 15, 2022. Mail your claim to the address shown 
                         on the back of your K-40H or K-40PT.
Where to File
                          Late Claims – Claims filed after the due date may be accepted whenever good cause exists, provided the claim 
                         is filed within four years of the original due date. Examples of good cause include, but are not limited to, absence of 
                         the claimant from the state or country or temporary illness of the claimant at the time the claim was due. When filing 
                         a late claim, enclose an explanation with documentation as to why it is late. If your claim will be late because you 
                         have an extension of time to file your income tax return, enclose a copy of that federal extension with your claim. 
                         NOTE: Kansas does not have a separate extension of time form.
                          WebFile is a simple, secure, fast and free Kansas electronic filing option. See back cover for details!

Refund                    This optional program provides eligible homeowners an opportunity to apply a portion of their anticipated 2021 
Advancement              Homestead or Property Tax Relief refund to help pay the first half of their 2021 property taxes. The amount of the 
Program                  advancement is based on the 2020 refund amount.
                          You may participate in this program by marking the Refund Advancement Program check box on your 2021 
                         Form K-40H (or Form K-40PT). See instructions on page 6 for additional information.

Signature and             If a claimant is incapable of signing the claim, the claimant’s legal guardian, conservator, or attorney-in-fact may 
Fraudulent               file the claim. When filing on behalf of an eligible claimant, a copy of your legal authority is required.
Claims                    These refund programs are designed to provide tax relief only to those that qualify. Fraudulent claims filed will 
                         be denied and may result in criminal prosecution.

Deceased                  When the person who has been the claimant for a household dies, another member of the household who qualifies 
Claimant                 as a claimant should file Form K-40H or K-40PT for the household. A separate claim on behalf of the decedent is 
                         not necessary.
                          If a member of the decedent’s household (such as a surviving spouse) does NOT qualify to be the claimant, or 
                         when there are no other members of a decedent’s household, a claim may be filed for a deceased claimant if the 
Use  the  steps  in  the decedent was a resident of Kansas all of 2021 but died before filing a claim (after December 31, 2020) or died during 
worksheet on page 6 to   2021 and was a Kansas resident the entire portion of the year he or she was alive.
compute a refund for a 
deceased claimant.        Required Enclosures for Decedent Claims. You must enclose a copy of the death certificate, funeral home 
                         notice, or obituary statement with a decedent’s claim, AND one of the following:
                          1)  If the estate is being probated, a copy of the Letters of Testamentary or letters of administration.
                          2)  If the estate is not being probated, a completed Form RF-9, Decedent Refund Claim.
                          Signature on a Decedent’s Claim. A decedent’s claim should be signed by the surviving spouse; executor or 
                         executrix; administrator; or other authorized person.

Amending                  If, after mailing your claim, you find there is an error that will affect your refund amount, file an amended claim 
a Claim                  after you receive your refund from the original filing. To file an amended claim, obtain another copy of Form K-40H 
                         or Form K-40PT, and mark the “amended” box located to the right of the county abbreviation. Enter the information 
                         on the claim as it should have been, and enclose an explanation of the changes. If an additional refund is due you 
                         will receive it in 10 to 12 weeks.
                          If the refund on the amended claim is LESS than the refund you received from the original claim, enclose a 
                         check or money order for the difference, made payable to the Kansas Department of Revenue. Write          Homestead 
                         Repayment - Amended Claim and include the last 4 digits of your Social Security number (example: XXX-XX-1234).

                                       REFUND PERCENTAGE TABLE
                               (For use in computing your refund on line 14 of Form K-40H)

If the amount on line 10,      Enter on      If the amount on line 10,          Enter on  If the amount on line 10,                Enter on
Form, K-40H is:                line 14:      Form, K-40H is:                    line 14:  Form, K-40H is:                          line 14:
$    0  to  $  6,000 ...............100%     $  13,001  to  $14,000 ................. 68% $  21,001  to  $22,000 ................. 30%
$  6,001  to  $  7,000 ................ 96%  $  14,001  to  $15,000 ................. 64% $  22,001  to  $23,000 ................. 25%
$  7,001  to  $  8,000 ................ 92%  $  15,001  to  $16,000 ................. 60% $  23,001  to  $24,000 ................. 20%
$  8,001  to  $  9,000 ................ 88%  $  16,001  to  $17,000 ................. 55% $  24,001  to  $25,000 ................. 15%
$ 9,001  to  $10,000 ................. 84%   $  17,001  to  $18,000 ................. 50% $  25,001  to  $26,000 ................. 10%
$  10,001  to  $11,000 ................. 80% $  18,001  to  $19,000 ................. 45% $  26,001  to  $36,600 ................... 5%
$  11,001  to  $12,000  ................ 76% $  19,001  to  $20,000 ................. 40% $  36,601 and over .......................... 0%
$  12,001  to  $13,000 ................. 72% $  20,001  to  $21,000  ................ 35%

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                                            LINE-BY-LINE INSTRUCTIONS

                   CLAIMANT INFORMATION                                     HOUSEHOLD INCOME — LINES 4 THROUGH 10
Social  security  number,  name  validation,  and  telephone            Lines 4 through 8 will contain the total annual income amounts 
number. Enter your Social Security number in the boxes above the        received by you and your spouse during 2021. The income of ALL 
name and address. (Do not enter the Social Security number under        other persons who lived with you at any time during 2021 will be 
which you are receiving benefits if not your own).                      entered on line 9, All Other Income. If a minor child or incapacitated 
Using CAPITAL letters, enter the first four letters of your last name   person holds legal title to the property, the income (wages, child 
in the boxes provided. If your last name has fewer than four letters,   support, etc.) will also be entered on line 9.
leave the remaining boxes empty.                                        If  the  income  amounts  requested  on  lines  5  through  8  were 
Enter the telephone number where you can be reached during              included on line 4, do not include them again on lines 5 through 8.
our office hours so that we may contact you if a problem arises while   Line 4 (2021 Wages OR Kansas Adjusted Gross Income AND 
processing your claim. The number will be kept confidential.            Federal Earned Income Tax Credit): If you are not required to file 
Name and address. PRINT or TYPE your name and complete                  an income tax return, enter in the first space the total of all wages, 
address – the physical location of your residence (not a P.O. Box),     salaries, commissions, fees, bonuses, and tips received by you and 
including apartment number or lot number.                               your spouse during 2021. If the amount of 2021 wages or Kansas 
Deceased claimant. If you are filing on behalf of a claimant            Adjusted Gross Income is negative, enter zero in the space provided. 
who is deceased, mark an “X” in the box, and enter the date of the      Enter this same amount in the purple boxes.
claimant’s death. Use the worksheet for Deceased Claimants on page      If you file a Kansas income tax return, enter in the first space your 
6 to figure the decedent’s refund. Be sure to enclose the additional    Kansas Adjusted Gross Income (KAGI) from line 3 of your Form 
documents required (see page 3).                                        K-40, adding back net operating losses or net capital losses. Enter 
Name or address change. If you filed a refund claim last year           in the second space, any federal Earned Income Tax Credit (EITC) 
and your name or address has changed, place an “X” in the box to        received during 2021. This is generally the amount shown on your 
the right of the address so we may update our records.                  2020 federal tax return, but could also include an EITC for a prior 
Amended claim. If you are filing an amended (corrected) claim,          year that was received in 2021. Add your KAGI and EITC together 
mark an “X” in the box. See further instructions on page 3.             and enter the total in the purple boxes. Important—If line 4 is your 
                                                                        KAGI plus EITC, enter on lines 5 through 8 only the income amounts 
       QUALIFICATIONS — LINES 1 THROUGH 3                               that are not already included in your KAGI on line 4.
To qualify, you must first have been a resident of Kansas all of        Line 5 (All taxable income other than wages and pensions 
2021. Next you must own and occupy your home – meaning that             not included in Line 4): Enter all taxable interest and dividend 
your name must be on the deed to the home. Contract for deed            income, unemployment, self-employment income, business or farm 
does qualify as ownership; however, a “rent to own” contract does       income, alimony received, rental or partnership income, the gain 
not qualify as ownership. If you were a Kansas resident all year and    from business or investment property sales, and any long term 
owned and occupied your home, complete ONLY the qualification line      capital gains that were included in federal adjusted gross income. 
that applies to your situation (i.e., if you are age 60 and also blind, A net operating loss or net capital loss may not be used to reduce 
enter your birthdate in the boxes on line 1 and skip lines 2 and 3).    household income. If you have nontaxable interest or dividends, 
                                                                        enter them on line 9, All Other Income.
Line 1 (Age qualification): If you were born before January 1, 
                                                                        If you used a portion of your homestead for rental or business 
1966, enter the month, day, and year of your birth. Add a preceding 
                                                                        income, enter the net rental or business income on line 5. Note: 
“0” for months and days with only one digit.
                                                                        Also complete the worksheet on page 5 to determine the property 
Line 2 (Disabled or blind qualification): If you are blind or           tax amount to enter on line 12.
totally and permanently disabled, enter the month, day, and year you 
                                                                        Line  6  (Total  Social  Security  and  SSI  benefits,  including 
became blind or disabled. (Veterans disability includes veterans                               Enter in the first space of line 6 the total 
                                                                        Medicare deductions):
50% or more permanently disabled.) The Kansas Department of 
                                                                        Social Security and Supplemental Security Income (SSI) benefits 
Revenue must have on file documentation of permanent disability or 
                                                                        received by you and your spouse. Include amounts deducted for 
blindness for your homestead claim. If you do not have documentation 
                                                                        Medicare, any Social Security death benefits, and any SSI payments 
you must enclose with Form K-40H either  1)a copy of your Social        not shown on the annual Social Security benefit statement. Do not 
Security statement showing that your disability began prior to 2021, 
                                                                        include Social Security or SSI “disability” payments.
or  2)Schedule DIS (from page 11) completed by your doctor.
                                                                        Enter the annual amount of any Social Security or SSI disability 
Line 3 (Dependent child qualification :)  If you have at least one      benefits in the Excluded Income section on the back of Form K-40H. 
dependent child, enter their name and date of birth (must be prior                         must enclose a copy of their benefit statement or 
                                                                        First time filers:
to January 1, 2021) in the spaces provided. NOTE: The child must        award letter with their claim to verify that the Social Security income 
have resided solely with the claimant the entire calendar year, be      is excludable. If you are not required to enclose a copy, be sure to 
under age 18 all of 2021, AND is or may be claimed as a dependent       keep one for your records as the Department reserves the right to 
by the claimant for income tax purposes.                                request it at a later date.
Surviving spouse: Mark this box if filing as surviving spouse 
(and not remarried) of a disabled veteran or an active duty service     If you do not have your annual Social Security benefits statement, 
member who died in the line of duty. The disabled veteran must meet     use the following method to compute the total received for 2021. Add 
the qualifications in line 2. Enclose with your K-40H a copy of the     the amount of your December 2021 check, plus the 2021 Medicare 
original Veterans Disability Determination Letter or letter from your   deduction of 148.50 (if applicable), and multiply by 12.
regional V.A. that includes the disability date prior to 2021 and the   EXAMPLE: Your December, 2021 social security check is $771.00 
                                                                        You are covered by Medicare. Your part B premiums are $148.50 
percentage of permanent disability being 50% or greater.                month ($1,782 per year). Compute your benefits as follows:
If you are not a Kansas resident and homeowner and do not meet one      $771.00 + $148.50 = $919.50. $919.50 X 12 months = $11,034.
of the other three qualifications, you do not qualify for this refund.  (enter $11,034 in the first space on line 6.)
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Multiply the total Social Security and SSI benefits received in2021                        Line 12 (2021 general property taxes):        Enter the total 2021 
by 50% (.50) and enter result in the purple boxes on line 6.                               general property tax you have paid or will pay, as shown on your real 
Line 7 (Railroad Retirement benefits and all other pensions,                               estate tax statement (taxes on property valued at $350,000 or more 
annuities, and veterans benefits): Enter the amounts received                              does not qualify). Do not include special assessment taxes, such as 
during 2021 from railroad retirement benefits (including Tier I— Social                    those levied for streets, sewers, or utilities; charges for services, such 
Security equivalent benefits) and veterans’ pensions and benefits.                         as sewer services; interest or late charges; or taxes on agricultural 
DO NOT include veteran or railroad retirement “disability” payments.                       or commercial land. NOTE: The 2021 property tax is payable in two 
Note: Veterans disability includes veterans 50% or more permanently                        installments – the first is due December 20, 2021 and the second is 
disabled and surviving spouses of deceased disabled veterans.                              due May 10, 2022. It is the total of both installments (whether paid 
Also include on line 7 the total of all other taxable and nontaxable                       or not) that is entered on line 12.
pensions and annuities received by you or your spouse that is not                          If you are filing on behalf of a claimant who died during     2021, 
already entered on line 4 or line 6, except Veterans’ and Railroad                         the property tax must be prorated based on the date of death. To 
Retirement “disability” payments.                                                          determine the property tax amount to enter here, use the steps for 
                                                                                           computing a decedent’s refund on the next page.
Line  8  (TAF  payments,  general  assistance,  workers’                                   If you have delinquent property tax, mark the box on line 12. 
compensation  and  grants  and  scholarships :)  Enter the                                 Your entire homestead refund will be sent to your county treasurer 
amounts received during  2021 in the form of: TAF (Temporary                               to pay the delinquent property tax.
Assistance to Families); welfare or general assistance payments; 
workers’ compensation; disability payments (excluding disability                                              2021 Property Tax Statement
payments received from Social Security, SSI, Veterans and Railroad                         You are not required to send a copy of your 2021 property tax 
Retirement, or pensions that you entered on line 4 or line 7); and                         statement with your completed K-40H; however, you may be asked 
grants, scholarships, and foster grandparent payments.                                     to provide it at a later date. If requested, submit a copy of your 
Line 9 (All other income. Enter the total amounts from the                                 2021 statement – NOT a basic receipt – to verify the property 
following list): Enclose with your claim a list showing the recipient(s),                  tax entered on line 12. The copy will not be returned. A property 
source(s), and amount(s) for the income entered on line 9.                                 tax receipt that contains a breakdown of property tax among the 
•  All income (regardless of source) received by adult individuals other                   general tax, special tax, fees, etc. (such as a receipt that is an exact 
than you and your spouse who lived in the homestead at any time during                     copy of the statement) is acceptable. The annual statement from 
2021. For those who lived with you less than 12 months, include only the                   your mortgage company and property tax receipts are NOT 
income they received during the months they lived with you. Also list these                acceptable. If you need a copy of your property tax statement, you 
individuals in the Members of Household section on the back of the claim.                  may request one through the office of your county clerk.
•  The income (child support, SSI, wages, etc.) of a minor child or 
incapacitated person, when that person is an owner of the homestead                                  Mobile and Manufactured Homeowners
or is on the rental agreement.
•  Any other income outlined as “household income” on page 2 that is not                   If you own your mobile home/manufactured home, enter on line 12 
already entered on lines 4 through 8.                                                      the personal property taxes you paid on your home, and the general 
Line 10 (Total Household Income): Add lines 4 through 9 and                                property tax paid on the land. If you own your mobile home, but rent 
enter total. If the amount is negative, enter zero in the space provided.                  the land or lot on which it sits, enter on line 12 the personal property 
If more than $36,600 you do not qualify for a homestead refund.                            tax you paid on the mobile home. You may not claim the general 
Important: To expedite your refund, enclose a copy of pages 1 and                          property tax paid on the rented property.
2 of your federal Form 1040, statements from DCF (formerly SRS)                                                Farm Owners
and Social Security; and other documentation for income amounts                            If your homestead is part of a farm covered by a single property 
shown on lines 4 through 9.                                                                tax statement, you may use only the general property tax paid on 
                                                                                           the HOMESITE.
            REFUND — LINES 11 THROUGH 15
                                                                                           Line 13 (Amount of property tax allowed; cannot exceed 
Line 11 (Percent of property for rental or business use): If                               $700): Enter amount reported on line 12 or $700, whichever is less.
part of your homestead was rented to others or used for business                           Line  14  (Homestead  refund  percentage):  Your  refund 
purposes during 2021, you may claim only the property taxes paid                           percentage is based on your total household income on line 10. 
on the portion that was used for personal purposes. Complete the                           Using the table at the bottom of page 3, find your income and enter 
following worksheet to determine the percent of rental or business                         the corresponding percentage on line 14. If the percentage is less 
use to enter on line 11 and property tax amount to enter on line 12,                       than 100%, leave the first box blank.
Form K-40H. Note: Include the income received from the rental or                                                               Multiply line 13 by the percentage 
                                                                                           Line 15 (Homestead Refund):
business use of your homestead on lines 4 or 5 of Form K-40H.                              on line 14 and enter the result. If the amount is less than $5, it will 
    WORKSHEET for RENTAL or BUSINESS USE of HOME                                           not be refunded. You will receive a refund in the amount shown 
                                                                                           on line 15 if there are no corrections made to your claim; you did 
    If you filed Schedule C Form 1040, complete only lines 4, 5 and 6.                     not participate in the optional refund advancement program (see 
1. Total number of rooms in your homestead ......................            _____________ page 3); you have no delinquent property taxes due to your County 
2. Number of rooms rented or used for business ................              _____________ Treasurer; and you owe no other debt to the State of Kansas (see 
3. Rental/business use percentage. Divide line 2 by                                        Debtor Set-Off that follows).
line 1. Enter result here and line 11 of Form K-40H ........                ____________ % IMPORTANT: Instructions for the back of your claim are on page 6. 
4. Total 2021 general property tax .......................................   _____________ Before mailing it be sure to complete all sections, sign the claim, and 
5. Multiply line 4 by line 3 (also include any property tax                                enclose all required documentation.
deduction claimed on federal Schedule C)
This is the rental/business portion of the property taxes. ...               _____________                     Debtor Set-Off
6. Subtract line 5 from line 4. This is the general                                        If you owe a delinquent debt to the State of Kansas (such as child 
property tax on the nonbusiness portion of your                                            support, student loan, medical bills, or income tax), your refund will 
homestead. Enter result on line 12, Form K-40H ............                  _____________
                                                                                           be applied to that debt first and any remaining refund will be sent to 
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you. Be advised that the set-off process will cause a delay of up to                             On line (g), enter wages received by a minor child and any other 
12 weeks for any remaining refund.                                                               income not considered “household income” as outlined on page 2. 
                         Deceased Claimants                                                      First time filers must enclose a copy of their benefit statement or 
                                                                                                 award letter with their claim to verify that the Social Security income 
If filing on behalf of a claimant who died during 2021, the refund                               is excludable. Previous filers should keep a copy for their records 
amount is prorated based on the decedent’s date of death. The taxes                              as the Department reserves the right to request it at a later date.
(line 12) are also prorated based on the decedent’s date of death. 
Use the following steps to compute a refund on behalf of a decedent.                             MEMBERS OF HOUSEHOLD (BACK OF CLAIM FORM)
See page 3 for required enclosures.
                                                                                                 All claimants must complete this section. As the claimant, enter 
REFUND COMPUTATION FOR DECEASED CLAIMANT                                                         your information on the first line. Then enter the name, date of birth, 
1.  Complete lines 1 through 11 of K-40H or 1 through 10 of K-40PT.                              and other requested information for EACH PERSON (adults and 
2.  Compute allowable property tax paid by decedent to date of death. Using                      children) who lived with you at any time during 2021.
the table below, multiply the total 2021 property taxes by the applicable                        If the person lived with you all year, enter “12” in the Number of 
percentage for the month of the decedent’s death. Enter result on line                           months resided in household column and indicate whether their 
12 of K-40H or line 11 of K-40PT.
EXAMPLE: If claimant died in August 2021 and the 2021 taxes were $645, the                       income is included as part of the Household Income reported on lines 
property tax paid to date of death is 8/12ths (.667) of $645 for a result of $430                4 through 9 of K-40H. NOTE: For a child born during 2021, enter only 
($645 X .667 = $430).                                                                            the number of months from the date of birth to the end of the year. 
3.  Complete lines 13 and 14 of the K-40H; then continue by completing lines                     For example, enter “6” for a child born July 10, 2021.
4 through 6 of this worksheet. If filing a K-40PT, skip lines 4 through 6 
and follow the instructions for K-40PT below.                                                    Signature: You, as the claimant, MUST sign the claim. If the claim 
4.  Multiply line 13 of K-40H by line 14 of K-40H. Enter result  ______________ .                was prepared by another, the preparer should also sign in the space 
5.  Enter percent from table below for month of decedent’s death _________ .                     provided, and supply a daytime phone number.
6.  Multiply the result from line 4 by the percent in line 5. Enter the result                   Preparer authorization box: It may be necessary that we contact 
here  _________________  and on line 15 of K-40H.                                                you about your claim. By marking the box above the signature line, 
K-40PT: Multiply amount on line 11 of K-40PT by 75% (.75). Multiply                              you are authorizing the department’s director or their designee to 
the result by the percentage from the following table for the month of the                       discuss your claim and any enclosures with your preparer. If a paid 
decedent’s death. Enter this amount on line 12 of K-40PT.                                        preparer is completing your return, they must sign and provide their
Month Percent            Month Percent            Month                       Percent            preparer tax identification number (PTIN).
January  .083            May    .417              September                   .750               If the claim is being filed on behalf of a decedent, the surviving 
February  .167           June   .500              October                     .833
March  .250              July   .583              November                    .917               spouse or executor/executrix must sign it. See Deceased Claimants 
April  .333              August .667              December  1.000                                on page 3 for additional information and required enclosures.
                                                                                                 If the claimant is incapable of signing the claim, the person 
       2022 Refund Advancement Program Box                                                       authorized to sign MUST sign and enclose a copy of the appointing 
      (See additional information about this program on page 3)                                  documentation (i.e., guardian, conservator, power of attorney).
By checking this box, you are requesting that the Department                                     MAILING YOUR CLAIM: To prevent a delay in your receiving your 
of Revenue electronically transfer your  2022 advancement                                        refund, be sure that you have a correct and complete claim. Before 
information directly to the County Treasurer to help pay the first half                          mailing it, please be sure you have:
of your property taxes. If you do not check this box, you cannot 
participate in the 2022 advancement program, in which case none                                   written your numbers clearly in each box;
                                                                                                 
of your 2022 refund will be used to pay your 2022 property taxes.                                  completed all required information and signed the claim;
                                                                                                 
As a participant in this program, your 2021 refund will be used                                    kept a complete copy of your claim for your records;
                                                                                                  enclosed,  with Form K-40H, a copy of your Social  Security 
to pay back the amount the Department of Revenue advanced the                                      disability award letter or Schedule DIS completed by your physician 
county for your property taxes in December 2021. If there is a refund                              indicating date the disability began (disabled or blind claimants);
amount left over, it will be sent to you in a check. To determine the                             placed all forms loosely in the envelope. DO NOT staple, tape or 
amount of your refund check, complete the following worksheet.                                     use any type of fastening device on documents.
               Refund Advancement Worksheet                                                      AFTER YOU FILE: Keep a copy of your claim and all supporting 
                                                                                                 documents. If you have a problem later and need to contact the 
1. 2021 refund from line 15 of Form K-40H or line 12                                             Department of Revenue, it will save time if you have a copy of your 
of form K-40PT ............................................................ $  _________________
2. 2021 refund advancement amount from your                                                      claim with you. Keep copies of all documents for at least four years.
advancement letter ...................................................... $    _________________                  Processing Refund Claims
3. Subtract line 2 from line 1 ........................................... $   _________________ Normal processing time for an error-free and complete paper- 
You will receive the amount on line 3 in a check from the Department of                          filed homestead refund claim is 20 to 24 weeks. Claims requiring 
Revenue if you have no other delinquent debts due the state of Kansas                            correspondence will take longer. Information for checking the status 
(see Debtor Setoff.)                                                                             of your refund can be found on the back cover of this booklet.
                                                                                                 If you have a refund due on the K-40H (or K-40PT) and K-40 
If your 2021 refund (line 15, K-40H or line 12, K-40PT) is LESS                                  forms, wait until both returns are processed before expecting a 
than the advancement amount (line 2 of the Refund Advancement                                    refund check. Your refund(s) are subject to debtor set-off for other 
Worksheet), you should pay the difference when you file your 2021                                delinquent debts owed to the State of Kansas or County Treasurer.
K-40H or K-40PT. Make your check or money order payable to the 
Department of Revenue and include the tax year and last 4 digits of                                Correspondence from the Department of Revenue
your Social Security number (example: XXX-XX-1234).                                              Should you receive a letter from the Department of Revenue 
                                                                                                 about your claim, please respond to it immediately. Processing 
      EXCLUDED INCOME (BACK OF CLAIM FORM)                                                       time necessary for a typical refund claim starts the day the missing 
Enter in this section the total received during 2021 by all household                            information is received by the department. If you have questions 
members (including minor children) from each of the sources listed                               about the letter or wish to discuss your claim in person, contact our 
in (a) through (f).                                                                              Taxpayer Assistance Center (see back cover).
Page 6



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                                                                                                                               2021
K-40H(Rev. 7-21)                                                                                                                                                                                                                    134121
                                                                                              KANSAS HOMESTEAD CLAIM
DO NOT STAPLE
                                                                         FILE THIS CLAIM AFTER DECEMBER 31, 2021, BUT NO LATER THAN APRIL 15, 2022
                                                        Claimant’s                                                   First four letters of        Claimant’s
                                                        Social Security                                              claimant’s last name.        Telephone
                                                        Number                                                       Use ALL CAPITAL letters.     Number
                                              Your First Name                                 Initial                Last Name                                                        Mark this box if claimant is
                                                                                                                                                                                      deceased (See instructions)...........
                                                                                                                                                                                      Date of Death                                 ________________________
                                              Mailing Address (Number and Street, including Rural Route)                                                                              IMPORTANT:  Mark this box if
                                                                                                                                                                                      name or address has changed.......
                                              City, Town, or Post Office                                                State  Zip Code          County Abbreviation
                                                                                                                                                                                      Mark this box if this is an
Name and Address                                                                                                                                                                      amended claim ..............................

                                                        TO QUALIFY YOU MUST HAVE BEEN A RESIDENT OF KANSAS THE ENTIRE YEAR OF 2021 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 1966) ..........................................
                                                        2. Disabled or blind for the entire year? Enter the date                     ENCLOSE Social Security Benefit 
                                                            disability began. See instructions...................                    Verification 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 2021)......................
                                Qualifications
                                                            Mark this box if you are filing 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 qualification and for required enclosures)

                                                        ENTER THE TOTAL RECEIVED IN 2021 FOR EACH TYPE OF INCOME. See instructions.
                                                        4. 2021 Wages OR Kansas Adjusted Gross Income (if negative, enter zero) $                ________________________ plus Federal
                                                           Earned Income Credit $ ________________________ . Enter the total .................................................................................                                              00
                                                        5. All taxable income other than wages and pensions not included in Line 4. Do not subtract net operating losses
                                                           and capital losses .....................................................................................................................................................                         00
                                                        6. Total Social Security and SSI benefits, including Medicare deductions, received in 2021 (do                    not include
                                                                                                                                                                                                                                                            00
                                                           disability payments from Social Security or SSI) $ ________________________     . Enter 50% of this total............................
                                                        7. Railroad Retirement benefits and    all other pensions, annuities, and veterans benefits (do not include                                                                                         00
                                                           disability payments from Veterans and Railroad Retirement) ............................................................................
                                                        8. TAF payments, general assistance, worker’s compensation, grants and scholarships.....................................                                                                            00
                Household Income
                                                        9. All other income, including the income of others who resided with you at any time during 2021 ......................                                                                             00

                                                        10. TOTAL HOUSEHOLD INCOME (Add lines 4 through 9. If line 10 is more than $36,600 you do not qualify for a refund)                                                                                 00

                                                        11. Percent of the homestead property that was rented or used for business in 2021 (see instructions) .......................................                                                       %
                                                        12.2021 general property taxes, excluding specials. (Tax on property valued at            Mark this box if you have
                                                           more than $350,000 does not qualify. See instructions.)..............................  delinquent property tax.                                                                                  00
                                                        13.  Amount of property tax allowed. Enter amount from line 12 or $700, whichever is less...........................................................                                                00
                                                        14.  Using your total household income on line 10 and the Refund Percentage Table, enter your refund percentage....................                                                                 %
      Refund
                                                        15. HOMESTEAD REFUND (Multiply line 13 by percentage on line 14) ........................................................................................                                           00
                                                           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 2021 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
                                              Signature                                                                                    Tax Preparer’s PTIN, EIN or SSN:

                                                                                        IMPORTANT: Please allow 20 to 24 weeks to process your refund.

                                                                        COMPLETE THE BACK OF THIS FORM



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134221

Providing this information should speed the processing of your claim. Income reported here should not be included on line 10 of this form.
Enter in the spaces provided the annual amount of all other income not included as household income on line 10:

(a)  Food Stamps.............................. $ 00 (b)  Nongovernmental Gifts ......................... $ 00

(c) Child Support.............................. $ 00 (d)  Settlements (lump sum) ........................ $ 00
Disability (enclose documentation)............ $
(e)  Personal and Student Loans...... $ 00 (f) SSI, Social Security, Veterans or Railroad 00
Excluded Income
(g) Other (See instructions) Source ___________________________________________________________________________________ Amount $ 00

Complete the information below for ALL persons (including yourself) who resided in your household at any time during 2021. Indicate the number
of months they lived with you and whether or not their income is included on lines 4 through 9 of Form K-40H.
Number of Income
Name Date of Birth Relationship months resided included on Social Security Number
in household lines 4-9,
Yes/No

Members of Household

MAIL TO: Homestead Claim, Kansas Department of Revenue, PO Box 750260, Topeka KS 66699-0260



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                                                                                                                        2021                                                                                                         135321
K-40PT(Rev. 7-21)
                                                                        KANSAS PROPERTY TAX RELIEF CLAIM
DO NOT STAPLE
                                                                                                for Low Income Seniors
                                                                        FILE THIS CLAIM AFTER DECEMBER 31, 2021, BUT NO LATER THAN APRIL 15, 2022

                                                       Claimant’s                                             First four letters of       Claimant’s
                                                       Social Security                                        claimant’s last name.       Telephone
                                                       Number                                                 Use ALL CAPITAL letters.    Number

                                                       Your First Name                          Initial       Last Name                                                        Mark this box if claimant is
                                                                                                                                                                               deceased (See instructions)...........
                                                                                                                                                                               Date of Death ____________________
                                                       Mailing Address (Number and Street, including Rural Route)                                                              IMPORTANT: Mark this box if
                                                                                                                                                                               name or address has changed.......

                                                       City, Town, or Post Office                                 State      Zip Code    County Abbreviation
                                                                                                                                                                               Mark this box if this is an
Name and Address                                                                                                                                                               amended claim ...............................

                                                       To qualify for this property tax refund you must meet the household income
                                                       limitation and you must have been:                                                                                      NOTE: If you filed a Form K-40H for
                                                                                                                                                                               2021,  you                                            DO  NOT qualify  for  this
                                                                                                                                                                               property tax refund.
                                                       1. A resident of Kansas during the entire year of 2021;
                                                       2. A home owner during 2021; and,                                                                                       MONTH                                                 DAY     YEAR
                                                       3. Age 65 or over for the entire year. Enter your date of birth (must be prior to 1956).................................
                                Qualifications

                                                       ENTER THE TOTAL RECEIVED IN 2021 FOR EACH TYPE OF INCOME. See instructions.
                                                       4. 2021 Wages OR Kansas Adjusted Gross Income (if negative, enter zero) $         _________________________ plus Federal
                                                           Earned Income Credit $  ________________________ . Enter the total...................................................................................                                 00
                                                       5. All taxable income other than wages and pensions not included in Line 4. Do not subtract net operating losses
                                                           and capital losses ......................................................................................................................................................             00
                                                       6. Total Social Security and SSI benefits, including Medicare deductions, received in 2021 (do not include
                                                           disability payments from Social Security or SSI). ............................................................................................                                        00
                                                       7. Railroad Retirement benefits and all other pensions, annuities, and veterans benefits (do not include
                                                           disability payments from Veterans and Railroad Retirement) .....................................................................                                                      00

                                                       8. TAF payments, general assistance, worker’s compensation, grants and scholarships......................................                                                                 00
                Household Income
                                                       9. All other income, including the income of others who resided with you at any time during 2021 .......................                                                                  00

                                                       10. TOTAL HOUSEHOLD INCOME (Add lines 4 through 9. If line 10 is more than $20,900, you do not qualify for a refund)                                                                      00

                                                       11. General property taxes  paid timely in 2021, excluding specials. (Tax on property valued at more than $350,000 does
                                                           not qualify. See instructions on the back of this form.)......................................................................................................                        00

                                                       12. PROPERTY TAX REFUND. Multiply the amount on line 11 by 75% (.75). This is the amount of your refund.......................                                                            00
                                                           Important: If you filed Form ELG with your county, your refund will be reduced by the ELG amount applied to the
Refund                                                     first half of your 2021 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-40PT 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
                                              Signature
                                                                                                                                    Tax Preparer’s PTIN, EIN or SSN:

                                                                                       IMPORTANT: Please allow 20 to 24 weeks to process your refund.

                                                                       COMPLETE THE BACK OF THIS FORM



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                                                                                                                                        135421

                     Providing this information should speed the processing of your claim. Income reported here should not be included on line 10 of this form.
                     13. Enter in the spaces provided the annual amount of all other income not included as household income on line 10:

                     (a) Food Stamps.............................. $                       00 (b)  Nongovernmental Gifts ......................... $           00

                     (c) Child Support.............................. $                     00 (d) Settlements (lump sum) ........................ $            00
                                                                                              (f) SSI, Social Security, Veterans or Railroad
Excluded Income      (e) Personal and Student Loans...... $                                00     Disability (enclose documentation) ......... $               00
                     (g) Other (See instructions)  Source _____________________________________________________________________________ Amount $               00

                     14. List the names of ALL persons who resided in your household at any time during 2021. Specify the number of months they lived with you and
                     report their portion of income that is included in total household income on line 10 of this form.
                                                                                  Number of
                                                                       months resided         Their portion of income that is
                                           Name                        in household           included on line 10                       Social Security Number

                                                                                           $                         00
                                                                                           $                         00
                                                                                           $                         00

                                                                                           $                         00

Members of Household                                                                       $                         00

                                                                                           $                         00

                                                   FORM K-40PT LINE-BY-LINE INSTRUCTIONS
If you filed a Form K-40H for 2021, you cannot claim this refund.                             If  you  do  not  have  your  statement  of  Social  Security  benefits,  use  the
                                                                                              method given for line 6 of Form K-40H to compute your total received in
NAME AND ADDRESS                                                                              2021. Instructions are on page 4.
Use the instructions for Form K-40H on page 4 to complete the personal                        Lines 7 through 9: Use the instructions for lines 7 through 9 of Form
information at the top of Form K-40PT.                                                        K-40H on page 5 to complete these lines on Form K-40PT.
QUALIFICATIONS                                                                                Line 10: Add lines 4 through 9 and enter total. If the amount is negative,
Lines 1 through 3: You must have been 65 years of age or older (born                          enter zero in the space provided. If more than $20,900 you do not qualify for
before January  1,  1956), a               resident of Kansas          all of 2021 and a home a homestead refund.
owner during 2021. If you meet these qualifications, enter your date of birth                 REFUND
on line 3.
                                                                                              Line 11: Enter the total 2021 general property tax you paid as shown on
HOUSEHOLD INCOME                                                                              your real estate tax statement. Enter only    timely paid tax amounts. For a
Enter on lines 4 through 8 the annual income amounts received by you and                      list of items that you cannot include see the instructions for line 12 of Form
your spouse during 2021. Enter on line 9 the income of ALL other persons                      K-40H on page 5.
who lived with you at any time during 2021.                                                   If you are filing on behalf of a claimant who died during       2021, the property
Lines 4 and 5:       Use the instructions for lines 4 and 5 of Form K-40H that                tax must be prorated based on the date of death. To determine the property tax
begin on page 4 to complete lines 4 and 5 of Form K-40PT.                                     amount to enter here, follow the instructions for deceased claimants on page 6.
Line 6: Enter the total Social Security and Supplemental Security Income                      Line 12: Multiply the amount on line 11 by 75% (.75). This is the amount
(SSI) benefits received by you and your spouse. Include amounts deducted                      of your property tax refund.
for Medicare, any Social Security death benefits, and any SSI payments not                    EXCLUDED INCOME
shown on the annual benefit statement.              Do not include Social Security            Line 13: To speed the processing of your refund, list in items (a) through
or  SSI  “disability”  payments.               (NOTE:  Social Security disability or SSI      (g) all other income that you did not include on line 10. For more information
payments become regular Social Security payments when a recipient reaches                     on what to include here, see Excluded Income on page 6.
full retirement age. These Social Security disability payments, that were once                Line 14: List all persons who resided in your household at any time during
Social Security disability or SSI payments, are NOT included in household                     2021. Complete all requested information for each person. If more space is
income.) Enter the annual amount of any Social Security disability benefits                   needed, enclose a separate sheet.
and Social Security payments of a person who has reached full retirement
age who had previously been receiving Social Security disability payments,                    SIGNATURE
in the Excluded Income section on the back of Form K-40PT and enclose a                       You, as the claimant,                     MUST  sign  the  claim.  See the instructions for
benefit statement or award letter with your claim.                                            Signature on page 6.

                     MAIL TO: Homestead Claim, Kansas Department of Revenue, PO Box 750260, Topeka KS 66699-0260



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                                                                                                                          130318
                                   2021 KANSAS 
DIS(Rev. 7-21)                     CERTIFICATE OF DISABILITY

  If you are claiming homestead benefits because of disability, this form must be completed by a duly licensed physician and 
enclosed with your Homestead Claim, Form K-40H. Instead of this schedule, you may enclose a copy of your Social Security 
certification of disability letter that shows you are receiving benefits based upon a total and permanent disability which prevented 
you from being engaged in any substantial gainful activity during the entire calendar year of 2021. You may enclose a copy of 
your original Veterans Disability Statement or request a letter from your regional Veterans Administration that includes your 
disability date and percentage of permanent disability. Annual income derived from any substantial gainful activity during 2021 
must not exceed the limits set by the Social Security Administration for 2021: $15,720 if the impairment is other than blindness; 
$26,280 if the individual is blind.

NAME OF PERSON EXAMINED __________________________________________________________________________________________________________________________________________________

SOCIAL SECURITY NUMBER ______________________________________________________________________________________________________________________________________________________

ADDRESS _____________________________________________________________________________________________________________________________________________________________________________________
                                   Street or RR (Include apartment number or lot number)

______________________________________________________________________________________________________________________________________________________________________________________________________
                       City                                                                                         State Zip Code

1. Does the individual qualify as having a disability preventing them from engaging in any substantial gainful activity by reason
  of any medically determinable physical or mental impairment which can be expected to result in death and/or has lasted
  for the entire year of 2021?
                                   o               YES                                           o                NO

2. Nature of disability  __________________________________________________________________________________________________________________________________________________________________

       _______________________________________________________________________________________________________________________________________________________________________________________________

3. When was the condition originally diagnosed? _______________________________________________________________________________________________________________________

                                   CERTIFICATION OF PHYSICIAN

I, ______________________________________________________________________________________________________________ , certify that I have personally examined the physical 
and mental condition of the above named individual.

I declare under the penalties of perjury that to the best of my knowledge and belief, this is a true, correct and complete statement.

SIGNATURE OF PHYSICIAN ______________________________________________________________________________________________________________________________________________________

PHYSICIAN’S NAME ____________________________________________________________________________________________________________________________________________________________________
                                                   Please type or print

BUSINESS ADDRESS _________________________________________________________________________________________________________________________________________________________________
                                                       Street or RR

______________________________________________________________________________________________________________________________________________________________________________________________________
                       City                                                                                         State Zip Code

PHONE __________________________________________________________________________________________                    DATE _________________________________________________________________

                                                                                                                                  Page 7



- 12 -
              Filing. If you need help completing your claim, contact our Taxpayer Assistance Center. If you are 
Taxpayer 
              eligible, free tax preparation is available through programs such as VITA (offered by the IRS), AARP-
Assistance    Tax Aide, and TCE. These programs have sites throughout the state of Kansas. To find a site near you, 
ksrevenue.gov call 1-800-829-1040 or visit a local IRS office. To find an AARP site, call 1-888-227-7669 or visit 
              their website at aarp.gov/money/taxes/aarp_taxaide

                    Taxpayer Assistance Centers are available by appointment only
                 Go to ksrevenue.gov to set up an appointment at the Topeka or Overland Park office by using the 
                                                   Appointment Scheduler. 

                                    Topeka Office                        Overland Park Office
                           120 SE 10th Avenue - 1st Floor               7600 W. 119th St., Suite A
                               Topeka, KS 66612-1103               Overland Park, KS 66213-1128

                                             Hours: 8 a.m. to 4:45 p.m. (M-F)
                                                   Phone: 785-368-8222
                                                   Fax: 785-291-3614

              Refunds. You can check the status of your refund from our website or by phone. You will need the 
              Social Security Number and the expected amount of your refund. When you have this information, go 
              to ksrevenue.gov and click on Refund Status or call 785-368-8222.

              Forms.     If you choose to file paper, FILE the ORIGINAL form from this booklet, not a copy or a 
              form from  an  approved  software  package.  For  a  list  of  approved  vendors  go  to: https://
              www.ksrevenue.gov/softwaredevelopers.html

              WebFile    is a  simple, secure, fast and free Kansas electronic filing option. It does require internet
Electronic 
              access and you must have filed a 2020 claim. You will need to enter your last year’s refund amount to 
Filing        verify your identity. Go to our website to get started. If you need assistance signing into the system, 
ksrevenue.gov contact our office by email at kdor_TAC@ks.gov or call 785-368-8222.
              Forms K-40H and  K-40PT may be filed electronically using Kansas WebFile or through IRS e-File. 
              Both filing options are safe and secure and you will get your refund faster if you use direct deposit.

              IRS e-File is a fast, accurate, and safe way to file your claim online using an authorized IRS e-File
              provider. Ask your tax preparer about e-File or visit our website for a list of authorized e-File providers 
              and software products. Join the 1.3 million taxpayers that used IRS e-File last year!

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