800718
                                  REQUEST FOR COPY OF KANSAS TAX DOCUMENTS 

Preferred Method of Delivery :                 Email    or                    Mailing address
PART I – Taxpayer information 
Name (Taxpayer or Corporate Name)                                                            Your SSN No. 

Joint Filer’s Name                                                                           Spouse’s SSN No. 

Address                                                                                      Registration No.          Employer ID No. (EIN) 

City, State and Zip Code                                                                     Daytime Phone Number 

                                                                                             Email Address 
PART II —Mailing Information (if different from above) 

Name 

Address                                                                                      City, State, and Address 

PART III —Tax Return / Document Requested (see instructions) 
                                                                                                                      NUMBER OF   COST PER          AMOUNT
                                               YEAR/PERIOD    YEAR/PERIOD               YEAR/PERIOD YEAR/PERIOD       RETURNS     RETURN            DUE
 Individual Income & Food Sales (K-40)                                                                                         X  $ 5.00  =  $ 
 Fiduciary (K-41)                                                                                                              X  $ 5.00  =  $ 
 Homestead (K-40H)                                                                                                             X  $ 5.00  =  $ 
 Withholding Return/Report (KW-3/KW-5)                                                                                         X  $ 5.00  =  $ 
 Sales Tax (ST-16/ST-36)                                                                                                       X  $ 5.00  =  $ 
 Cigarette Tax Report                                                                                                          X  $ 5.00  =  $ 
 Tobacco Tax Report                                                                                                            X  $ 5.00  =  $ 
 Misc. Tax:                                                                                                                    X  $ 5.00  =  $ 
                                               YEAR/PERIOD    YEAR/PERIOD               YEAR/PERIOD YEAR/PERIOD 
 Corporate (K-120)                                                                                                             X  $20.00  =  $ 
 Privilege (K-130)                                                                                                             X  $20.00  =  $ 
 Small Business/Partnership (K-120S)                                                                                           X  $20.00  =  $ 
 Federal Corporate (see instructions)                                                                                          X  $20.00  =  $ 
                                                     TAX TYPE OR  OCUMENT D ESCRIPTIOND                       YEAR 
 Copy of Refund Check                                                                                                          X  $ 5.00  =  $ 
 Copy of Tax Warrant                                                                                                           X  $15.00  =  $ 
 Copy of Satisfaction of Judgment (  Please 
     see special instructions on page 2 before                                                                                  X  $ 5.00  =  $ 
     requesting this document  )                                                                                                X  $ 5.00  =  $ 
 Transcript of Account                                                                                                         X  $ 5.00  =  $ 
 Other (see instructions)                                                                                                      X  $       =  $ 
Total number of returns/documents and total cost (see instructions)                                                                               $ 

PART IV — Signature and Date (read carefully before signing) 
I request the Director of Taxation furnish me with a copy of items checked. Under the penalties of perjury I declare that the information 
furnished above, to the best of my knowledge, is true, correct, and complete. I further declare that I am the taxpayer, officer for the 
taxpayer, or authorized tax preparer and have authorization to receive this information. 

                           Printed Name and Title                                                              Name of Your Business/Organization 

                                  Signature                                                                            Date 
DO-41 Rev.04-2 4

                                INSTRUCTIONS FOR COMPLETING FORM DO-41 

                                                                     or money order  payable, in the  amount due, to the 
            GENERAL INFORMATION                                      “Kansas Department of Revenue.” 
Use this form to request copies of filed returns and/or 
reports filed with the Kansas Department of Revenue.                 PART IV— Signature and Date 

The Kansas Department of Revenue will provide records                This form must be signed and dated by the taxpayer, 
upon a direct match. If you have not provided enough                 officer for the taxpayer, or authorized tax preparer. 
information to establish a direct match, we will contact
you for additional information.                                      Enclose your check or money order with this form and 
No refunds will be issued for requests made in error                 mail it to the following address: 
or for returns or reports that are not on file.                                         Record Requests 
                                                                                Kansas Department of Revenue 
            SPECIFIC INSTRUCTIONS                                                                   PO Box 3506 
                                                                                Topeka, KS 66601-3506 
PART I — Taxpayer Information 
                                                                     When your returns/documents have been retrieved, a 
Provide information as requested. Be sure to include                 copy of them will  be mailed to the address you have 
a daytime phone number in case we need to reach you                  provided on this form. 
during office hours. Please also indicate which method
                                                                     If you prefer, you may use             air express as a method of 
you would prefer to receive this records request. Email
(please provide email address in the space provided) or              delivery, but you  will be  responsible for the charges. 
regular mail which will be sent to the address listed on             Payment  must be made  directly to the delivery service 
the form.                                                            and  you  must  provide  the  Kansas  Department  of 
                                                                     Revenue with a prepaid envelope or an account number 
PART II — Mailing Information                                        for such delivery. 
                                                                     NOTE:  Tax  records  are  considered  confidential 
If the address provided in PART I is different than the 
                                                                     documents  and  are  held  in  strict  confidence  by  law; 
address where your return(s) are to be mailed, then
                                                                     therefore, faxing them is not a delivery option. 
complete PART II. 
                                                                                FEE STRUCTURE FOR DOCUMENTS 
PART III — Tax Return/Document Requested 
                                                                                NOT LISTED ON THIS FORM 
Indicate the return(s) you are requesting by marking                 • Copy charge for each page is $0.25. 
the appropriate box(es) and specifying the tax year(s).              • Search charge (staff time per hour) $25.00. 
Mark the “Misc. Tax” box for tax returns not listed and
enter the tax type in the space provided (i.e., liquor               • Computer time (staff time per hour) $60.00. 
enforcement, liquor drink, transient guest, motor fuel,              • Mail charge for first 5 pages is $0.40 and $0.25 for 
IFTA, etc.); then specify the tax year(s).                             each additional 5 page increments. 
                                                                     Copy and Search Charge Fees: The 25-cent copy charge 
          SATISFACTION OF JUDGMENT 
                                                                     is  a per page charge which is principally assessed  to 
     If you are requesting a copy of a Satisfaction of Judgment      reimburse the agency for routine costs of retrieving records 
(SOJ) please see that your case meets the following criteria 
                                                                     which are requested with specificity and are held within the 
before using this form  to make your request. 
   • Was the Tax Warrant paid in full, including all fees,           agency's   current        file system. It does not include the cost of 
penalties, and interst prior to 1-1-2024?                            more than one-tenth of an hour of research or access time 
     If you answered "yes" to the above question, then you may       required to determine the location of records not readily 
use this form to request a copy of your SOJ. If you answered         accessible,  to  determine  what  specific  records  meet 
"No" to the above question, then you will need to follow the         request criteria,  to segregate  public  from non-public 
instructions below.                                                  information  to  access records from archives and  other 
    To obtain a copy of the Satisfaction of Judgment for 
Johnson County, please visit: https://public.jococourts.org. For     similar necessary services. For such services in providing 
all other counties, please visit:  http://prodportal.kscourts.org/   access or copies, the $25 per hour search charge may be 
prodportal.                                                        , assessed, to be billed by the tenth of an hour. 
For corporate, privilege and small  business returns                 Mail Charge Fee: The mail  charge may be assessed in 
specify the year ending date(s).                                     addition to the copy charge when mail service is requested. 
To request a copy of a refund check, a tax warrant, a                For up to and including the first five pages, 40 cents may 
Satisfaction of Judgment, or an account transcript, mark             be charged,  plus  an  additional 25 cents for up to and 
the appropriate box and enter the tax type and year. For             including each additional five pages. 
documents that are not  listed  in this section, mark the 
“Other” box and provide a description under “Tax Type 
or Document  Description.” If the document you are 
requesting can  be found, and a copy provided, the 
Kansas  Department  of  Revenue  will  use  the              fee 
structure in the next column to compute the amount you 
owe and send you a bill. 
Complete Part III by totaling the “Number of Returns” 
column and the “Amount Due” column. Make your check