PDF document

- 1 -

City of Kansas City, Missouri - Revenue Division
RD-109
2022 WAGE EARNER RETURN
EARNINGS TAX

Phone: (816) 513-1120
E-file: kcmo.gov/quicktax

First Name: Middle Name: Last Name:
SSN: Street Address: Unit:
Account ID: City: State: Zip:

The Revenue Division does not allow joint filings - DO NOT INCLUDE YOUR SPOUSE'S INCOME
Period From: Period To:

1. Enter "X" in box if amended return 1 DOLLARS CENTS
2. Wages, tips, other compensation 2 $ .
3. Amount of nonresident or part-time resident deduction (RD-109NR, Line 5) 3 $ .
4. Total taxable wages (Line 2 less Line 3) 4 $ .
5. Earnings tax (1% of Line 4) 5 $ .
6. Earnings tax paid with extension RD-112 6 $ .
7. Local tax withheld by employer as shown on W-2 7 $ .

8. Earnings tax paid to other city (residents only, not to exceed Line 5) 8 $ .
9. Tax Due (Line 5 less Lines 6, 7 and 8, not less than 0) 9 $ .
10. Penalty (5% per month, not to exceed 25%) 10 $ .
11. Interest (1% per month until tax is paid in full) 11 $ .
12. Total Amount Due (sum of Lines 9, 10, and 11) 12 $ .
(Lines 6 + 7 + 8 less 5)
13. Overpayment to be refunded (No refunds less than $1.00) 13 $ .
14. Amount Paid 14 $ .
Complete this section for direct a. Routing Number 15a
deposit of your checking or savings
15. Refund: account (first-time filers are not b. Account Number 15b
eligible for direct deposit and will
receive a paper check). c. Account Type 15c Checking: Savings:
NOTES:
Do not file this form if your 1% earnings tax is fully withheld. If you are requesting a refund, submit Form RD-109 and Form RD-109 NR.
File this return on or before April 15th.
The Revenue Division and the IRS routinely share computer tapes and audit results. Differences, other than those allowed under City
Ordinance, will be identified and may result in an audit or further investigation.
Do not include Business Income on this form.
Write your SSN on your check.

DO NOT SEND CASH. Make check payable to: KCMO City Treasurer
Mail to: City of Kansas City, Missouri, Revenue Division, PO Box 842707 Kansas City, MO 64184-2707
For changes to name, address or FEIN/SSN, please contact us at revenue@kcmo.org or (816) 513-1120.
I authorize the Commissioner of Revenue or delegate to discuss my return and attachments with my preparer. Yes No
Under penalties of perjury, I declare this return to be true, correct, and complete accounting for the taxable year
stated.

Print Name of Taxpayer Signature Title Date Phone

Preparer Name (if other than taxpayer) Signature Title Date Phone

- 2 -

Enlarge image

City of Kansas City, Missouri - Revenue Division
RD-109NR
2022 WAGE EARNER RETURN
EARNINGS TAX NONRESIDENT SCHEDULE
Legal Name:
SSN:
Account ID:

A.
Occupation Daytime Phone
B. RESIDENT / NONRESIDENT STATUS
Nonresident for entire year Part Year Resident

Resident from : / / to : / /
Nonresident from : / / to : / /
MM DD YY MM DD YY
C. NON-RESIDENCY ALLOCATION FORMULA
If not using a standard 260 days, please explain your reason below and method of calculation (REQUIRED)

1. Total days worked everywhere. (A STANDARD WORK YEAR IS 260 DAYS)
You may not deduct vacation, sick, holiday or other leave from total working days 1
(You may not deduct days lived in the City)
2. Actual days worked outside the city. 2
You may not deduct vacation, sick, holiday or other leave as days worked outside the city
3. Percentage of days worked outside the city (Line 2 divided by Line 1) 3 %
DOLLARS CENTS
4. Gross wages per Federal W-2 (Box 1 on W-2) 4 $ .

5. Non-residency deduction (Line 4 x Line 3) 5 $ .
Enter amount on Line 3 of RD-109

D. 1. Amount of severance pay included in your compensation 1 $ .

2. Date of separation 2 / /
MM DD YY
E. LIST BELOW THE RECORD(S) YOU MAINTAIN TO SUPPORT CALCULATIONS FOR DAYS WORKED OR LIVED OUTSIDE OF THE CITY

PLEASE NOTE: Although you are not submitting documentation at this time to support your claim of days worked outside of the city
you may be requested to submit this documentation at a later date for verification before refund is approved.
F. Employer information is required to verify claims for non-residency / days worked outside of the city.
You must provide the following information before your refund request can be processed.
Employer's name:

Employer's email address:

Name of employer's contact person:

Contact person's phone number:

Address of your primary work location:

Under penalties of perjury, I declare this return to be true and correct. Yes No

Signature Date Email address Phone

- 3 -

Enlarge image

                                  City of Kansas City, Missouri - Revenue Division
   RD-109
   2022                           WAGE EARNER RETURN
                                  EARNINGS TAX

                                  Phone: (816) 513-1120
                                  E-file:         kcmo.gov/quicktax

                   GENERAL INSTRUCTIONS FOR COMPLETING FORM RD-109
1. Who must file:

•  Every resident individual who derives income from salaries, wages, commissions or other compensation for which the tax has not been withheld by  
   the resident's employer(s). If your income is derived from the ownership of a business or other
   self-employment, you MUST file a Profits Return - Earnings Tax (Form RD-108).

•  Every nonresident individual working or providing services within the city who derives income from salaries, wages, commissions or other  
   compensation from which the tax has not been withheld by the employer.

•  Exception: Where city earnings tax has been withheld from an individual's entire taxable earnings by his or her employer(s), no further payment is  
   due and a return does not need to be filed.

2. When to file:

  •     The return is to be filed on or before April 15 of each year. Please file electronically at kcmo.gov/quicktax.

  •       Extension--An extension of time to file the Wage Earner Return - Earnings Tax (Form RD-109) may be obtained by filing Extension - Wage Earner  
    Return Earnings Tax (Form RD-112) with PAYMENT of the estimated tax due on or before April 15. Extension payment must be 90% of the tax due  
    to avoid penalty and interest.

3. Where to file:

  •   RETURNS AND SCHEDULES FOR REFUND REQUESTS SHOULD BE MAILED TO:
      City of Kansas City, Missouri, Revenue Division, PO Box 842707 Kansas City, MO 64184-2707

  •   EXTENSION REQUESTS SHOULD BE MAILED TO:
      City of Kansas City, Missouri, Revenue Division, PO Box 843825, KANSAS CITY, MO 64184-3825

                   The information below answers frequently asked questions. These lists are not comprehensive. 
                   Please contact the Revenue Division at (816) 513-1120 if you have further questions.
                   WHAT IS TAXABLE                                                                WHAT IS NOT TAXABLE

•         Salaries, wages, tips, bonuses, and commissions                •      Interest and dividends
•         Sick, vacation, severance pay and salary continuation          •      Social Security
          plans                                                          •      Pension benefits
•         Moving expenses reimbursement                                  •      Employer contributions to pension plans
•         Value of life insurance premiums over $50,000 of               •      Capital Gains
          coverage                                                       •      Unemployment or disability benefits
•         Nonqualified stock option distributions                        •      Insurance proceeds
                                                                         •      Gain on sale of home
                                                                         •      Estate income
                                                                         •      Employee contributions to deferred compensation
                                                                                plans such as 401(k) plans

- 4 -

Enlarge image

City of Kansas City, Missouri - Revenue Division
RD-109
2022 WAGE EARNER RETURN
EARNINGS TAX

Phone: (816) 513-1120
E-file: kcmo.gov/quicktax

INSTRUCTIONS FOR COMPLETING FORM RD-109 (continued)

Fill out your name, address, social security number and tax period.
Line 1. Put an "X" in box if this is an amended return.

Line 2. Enter total wages, tips, and other compensation. Attached copies of all W-2s (box 1) and 1099s (box 7).

Line 3. NONRESIDENTS OR PART-TIME RESIDENTS ONLY: Enter amount of nonresident or part-time resident deduction (Enter amount
from Line 5 of Form RD-109NR). Attach the Nonresident Schedule (Form RD-109NR).

Line 4. Subtract Line 3 from Line 2 and enter total taxable wages.

Line 5. Multiply Line 4 by .01 (1%) and enter earnings tax.

Line 6. Enter amount of tax paid with Extension - Wage Earner Return Earnings Tax (Form RD-112).

Line 7. Enter amount of local tax withheld by employer(s).

Line 8. RESIDENTS ONLY: Enter earnings tax or income tax paid to another city on Line 8 as a credit. This credit is allowed only to the
extent of the tax imposed by Kansas City (1% of taxable earnings) or actual tax paid, whichever is less.

Line 9. Enter amount due (Line 5 less Lines 6, 7, and 8). If negative, enter zero and go to Line 13.

Line 10. If amount on Line 9 is past due, add penalty at rate of 5% per month (not to exceed 25%) from due date to date of payment.

Line 11. If amount on Line 9 is past due, add interest at rate of 1% per month from due date until tax is paid in full.

Line 12. Enter total amount due (sum of Lines 9, 10, and Line 11).

Line 13. If the sum of Lines 6, 7, and 8 less Line 5 results in an overpayment, enter amount to be refunded. See Line 15, if you want to
receive your refund request via direct deposit.

Line 14. Enter amount paid. Write your social security number on check and make check payable to KCMO City Treasurer.

Line 15. DIRECT DEPOSIT: Choose direct deposit for a fast, simple, safe, secure way to have your refund deposited automatically to your
checking or savings account. Fill in boxes 15a, 15b, and 15c to request that your refund be issued via direct deposit. For security
purposes, first-time filers are not eligible for direct deposit and will receive a refund via a paper check.

Line 15a. The routing number must be nine digits. The first two digits must be 01 through 12 or 21 through 32. The number is located on
the left bottom corner of your personal/business checks.

Line 15b. The account number can be up to 17 characters (both numbers and letters). Include hyphens but omit spaces and special
symbols. The account number is to the right of the routing number on personal/business checks. Be sure not to include the
check number.

Line 15c. Check the box for the type of account that corresponds to the routing and account numbers listed on Lines 15a and 15b.

The City will issue a refund check if a direct deposit request is rejected by your financial institution.

BE SURE TO SIGN YOUR RETURN
DO NOT SEND CASH
Visit our website at kcmo.gov/tax for more forms and instructions.

- 5 -

Enlarge image

City of Kansas City, Missouri - Revenue Division
RD-109NR
2022 WAGE EARNER RETURN
EARNINGS TAX NONRESIDENT SCHEDULE

Phone: (816) 513-1120
E-file: kcmo.gov/quicktax

INSTRUCTIONS FOR COMPLETING FORM RD-109NR

Who must file a Wage Earner Earnings Tax Nonresident Schedule (Form RD-109NR):
The Nonresident Schedule should be used by nonresidents who have performed services within and outside the city. This form is used in
conjunction with the Wage Earner Return - Earnings Tax (Form RD-109) to calculate a refund or an overpayment of taxes for services
performed outside of Kansas City, Missouri. If you meet the qualifications above and are requesting a refund, this form must be attached
to Form RD-109 along with a current copy of your W-2(s). Residents living in the City for a partial year may use this formula to calculate
their deduction for wages earned while living and working outside the City. All wages earned while living or working in the City are subject
to tax.

Section A
Fill out occupation and daytime phone number.

Section B Resident / Nonresident Status
Check whether you were a nonresident the entire year or a part year resident. If a part year resident enter dates you were a
resident and dates you were a nonresident.

Section C Non-Residency Allocation Formula
1. Enter 260 for days worked everywhere. If not using a standard 260, enter days worked, write your reason and method of
calculation on the lines provided and attach supporting documentation.
2. Enter actual days worked outside the city.
3. Enter percentage of days worked outside the city. (Line 2 divided by Line 1)
4. Enter total gross wages of all W-2(s). (Box 1 on W-2)
5. Enter non-residency deduction. (Line 4 x Line 3). Enter this amount on Line 3 of Form RD-109.

Section D Non-Residency Allocation Formula
1. Enter amount of severance pay included in compensation.
2. Enter date of separation.

Section E
Enter type of record(s) you maintain to support your calculations for days worked in and outside of the city.

Section F
Fill out your employer's name and email address, your work location, and identify a contact person and their phone number.

GENERAL INFORMATION

Documentation may be requested from you during the review process to verify your days worked outside the city. Days worked outside
the city must reflect the number of whole days worked outside of the city. The number of work days for a standard work year is 260. Do
not deduct vacation, sick, holiday or other leave when calculating the number of days worked everywhere or outside the city. Any portion
of the day worked in the city is a full day in the city.

The following may delay issuance of your refund: failure to provide required information when requested, failure to use approved forms,
not able to verify days worked outside of the city, inconsistencies on returns, failure to sign return, incomplete supporting documentation.

When documentation is requested you must provide definitive details about the number of days worked outside of the city, including
dates, location, and business purpose. Types of documentation include, verifiable records such as: appointment calendar, work and/or
travel orders, time and/or payment records, travel logs, certain types of receipts, proof of change of address such as utility bills, lease
agreements, and property tax receipts.

Failure to provide documentation when requested will result in your refund being denied.

PDF file checksum: 3661591091

(Plugin #1/9.12/13.0)