Form K-45 - Application For Carry Back Of Net Operating Loss Refund

Form K-45 - Application For Carry Back Of Net Operating Loss Refund - 2010

K-45

KANSAS

(Rev. 7/10)

APPLICATION FOR CARRY BACK OF NET OPERATING LOSS REFUND

First Name(s) and Initial(s)

Last Name

Social Security Number

Home Address (Number and Street or Rural Route)

Spouse’s Social Security Number

City, Town or Post Office

State

Zip Code

Employer Identification Number

FILE THIS APPLICATION SEPARATELY FROM YOUR INCOME TAX RETURN

YOU MUST ENCLOSE A COPY OF YOUR FEDERAL FORM 1045 WITH THIS CLAIM

Taxable year of net operating loss:

(a) Calendar year January 1-December 31, _______ or

and ending

Did you experience a change in marital status or file any of the carry back years with a different filing status than

❑

the loss year?

Yes If yes you need to complete Schedule IV (see instructions).

Schedules I, II and IV have been provided to assist you in completing Schedule III. If further information is needed

concerning the computation of your net operating loss, you may contact: Kansas Department of Revenue, 915

SW Harrison St., Topeka, KS 66699-1000; phone (785) 368-8222.

SCHEDULE I

SCHEDULE II

KANSAS COMPUTATION SCHEDULE

KANSAS DISTRIBUTION SCHEDULE

(See Instructions)

LOSS YEAR

CARRY BACK YEARS

_________

(A)

(B)

(C)

(D)

1. Taxable income per Kansas return

2. Net operating loss from prior year.

3. Net capital loss………………………

4. Nontaxable capital gain…………....

5. Exemptions

6. Excess nonbusiness deductions….

7. Other adjustments:

a. Charitable contributions…………

b. Standard deductions…………….

c. _________________ ……………

8. Net operating loss……………………

9. Modified taxable income…………………………………………..

10. Net operating loss carry back:

a. Net operating loss absorbed in 3

preceding year………….

b. Net operating loss absorbed in 2

preceding year…………………………………

c. Net operating loss absorbed in 1

preceding year…...............………………………. ………………………..

11. Remaining unused net operating loss…………………………….. ………………………. ………………………..

NONRESIDENTS: A nonresident must determine the NOL as though he/she were a Kansas resident. The information shown on the

nonresident allocation percentage schedule is NOT used to determine a Kansas NOL. Please read the general instructions and the

instructions for completing the Form K-45 before completing your nonresident Kansas return.

Form K-45 - Application For Carry Back Of Net Operating Loss Refund - 2010

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