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Kansas Free Printable DIS Certificate of Disability Rev. 7-21 for 2022 Kansas Certificate of Disability

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Certificate of Disability
DIS Certificate of Disability Rev. 7-21

DIS 2021 KANSAS 130318 CERTIFICATE OF DISABILITY (Rev. 7-21) 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 PHONE __________________________________________________________________________________________ State Zip Code DATE_________________________________________________________________
Extracted from PDF file 2021-kansas-schedule-dis.pdf, last modified September 2020

More about the Kansas Schedule DIS Individual Income Tax TY 2021

We last updated the Certificate of Disability in January 2022, so this is the latest version of Schedule DIS, fully updated for tax year 2021. You can download or print current or past-year PDFs of Schedule DIS directly from TaxFormFinder. You can print other Kansas tax forms here.

Other Kansas Individual Income Tax Forms:

TaxFormFinder has an additional 73 Kansas income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form K-40 Individual Income Tax Return
Schedule S Individual Income Tax Supplemental Schedule
Form K-40V Kansas Payment Voucher
Form K-40ES Individual Estimated Income Tax Vouchers
Form K-40H Homestead Claim

Download all KS tax forms View all 74 Kansas Income Tax Forms

Form Sources:

Kansas usually releases forms for the current tax year between January and April. We last updated Kansas Schedule DIS from the Department of Revenue in January 2022.

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About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of Kansas Schedule DIS

We have a total of eight past-year versions of Schedule DIS in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:

2021 Schedule DIS

DIS Certificate of Disability Rev. 7-21

2020 Schedule DIS

2020 Homestead or Property Tax Refund for Homeowners Instruction Booklet Rev. 8-20

2019 Schedule DIS

DIS Certificate of Disability Rev. 7-19

2018 Schedule DIS

DIS Certificate of Disability Rev. 8-18

2017 Schedule DIS

DIS Certificate of Disability Rev. 7-17

2016 Schedule DIS

DIS Certificate of Disability Rev. 8-16

Homestead Claim 2015 Schedule DIS

2015 Homestead Claim Instructions and Forms

Homestead 2012 Schedule DIS

DIS Certificate of Disability (Rev. 8-12)

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Source: http://www.taxformfinder.org/kansas/schedule-dis