BEFORE THE COURT OF TAX APPEALS OF THE STATE OF KANSAS DIVISION OF TAXATION APPEAL APPLICANT: __________________________________________ Applicant Name __________________________________________ Applicant Address (Street or Box No.) __________________________________________ City State Zip
(For State of Kansas use only)
Applicant Phone #:(____)_____________________ Applicant E-mail: ___________________________ Fee:_____________ Rec. Date:________ ATTORNEY OR REPRESENTATIVE: (If applicable)* No Fee:__________ __________________________________________ Representative Name Title __________________________________________ Representative Address __________________________________________ City State Zip Atty/Rep Phone #:(_____)_____________________ Representative E-mail:________________________
*Note: If you are represented by an attorney or other individual, you must provide the Court with either an Entry of Appearance or a current Declaration of Representative form approved by the Court of Tax Appeals. Tax Representatives are not permitted to sign applications filed with the Court.
Amt Rec. __________ Ck #______________ Reason: ___________
Dept. of Revenue Docket # or Dept. of Revenue ID#:___________________________ Year/Years at issue:______________________________________ Tax at issue:____________________________________________ Please indicate-- Small Claims Division: _____
CTA-DT (Rev. 7/08)
Regular Division: _____
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Please explain the basis of your appeal: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________
Signature of Applicant: __________________________________
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DIVISION OF TAXATION APPEAL INSTRUCTIONS
If you wish to appeal the final determination from the Department of Revenue, file this application within 30 days from the date of the final determination from the Department of Revenue. Appeals can be filed with the Regular Division (K.S.A. 74-2438) or with the Small Claims and Expedited Hearings Division (referred to as "Small Claims")(K.S.A. 74-2433f). Indicate on the front of the form if appeal is to the Small Claims Division or the Regular Division of the Court of Tax Appeals. Small Claims appeals are limited to appeals where the amount of tax in controversy is less than $15,000 and the case does not involve the taxation of marijuana or controlled substances. Enclose any applicable filing fee(s) pursuant to K.A.R. 94-2-21. Checks or money orders should be made payable to the Court of Tax Appeals. For information regarding fees with the State Court of Tax Appeals, visit www.kansas.gov/cota/ or contact the Court at (785) 2962388.
This form along with a copy of the final determination from the Department of Revenue, a Declaration of Representative/Entry of Appearance form (if applicable) and applicable filing fee should be filed with: Secretary Court of Tax Appeals 915 SW Harrison, Ste 451 Topeka, KS 66612-1505 And a copy of the appeal should be filed with: Secretary of Revenue or Secretary of Revenue's Designee 915 SW Harrison Topeka, KS 66625-0001