FINANCE AND ADMINISTRATION CABINET
Department of Revenue
(As Amended at ARRS, April 11, 2012)
103 KAR 3:010. General Administrative Forms Manual.
RELATES TO: KRS 42.470, 61.870-61.884, 64.012, 131.010(9), 131.020, 131.030, 131.041, 131.051, 131.061, 131.081, 131.081(2), (9), (15), 131.110, 131.130, 131.130(3), (10), (11), 131.150, 131.155, 131.170, 131.181, 131.183, 131.190, 131.190(1), 131.240, 131.340, 131.500, 131.500(1), (2), (3), (9), (10), 131.510(1), (2)(a), (2)(b), 131.530, 131.540, 132.020, 132.130-132.160, 132.180, 132.190, 132.200, 132.220, 132.227, 132.230, 132.260, 132.270, 132.290, 132.310, 132.320, 132.450, 132.487, 132.510, 132.820, 132.990, 133.045, 133.110, 133.120, 133.130, 133.240, 134.020, 134.390, 134.420, 134.430, 134.440, 134.500, 134.580(4), 134.590, 134.800, 134.805, 134.810, 134.815, 134.820, 134.825, 134.830, 135.010, 135.020, 135.050, 136.020, 136.050, 136.070, 136.071, 136.0704, 136.090, 136.100, 136.115-136.180, 136.1873, 136.310, 136.320, 136.330, 136.335, 136.377, 136.392, 136.545, 136.575, 136.600-136.660, 137.130, 137.160, 138.448, 138.885, 139.185, 139.200, 139.240, 139.330, 139.390, 139.550, 141.0401(5), 141.0401(6), 141.050(4), 141.210, 141.235, 141.340(2), 142.010, 142.050, 142.321, 142.327, 142.357, 143.030(1), 143.037, 143.040, 143.050, 143.060(1), 143.085, 143.990, 143A.010, 143A.030, 143A.035, 143A.037, 143A.080, 143A.090, 143A.100(1), 143A.991, 154.22-050, 154.22-060, 154.22-070, 154.23-010, 154.24-110, 154.24-130, 154.26-090, 154.28-090, 154.34-010, 155.170, 160.613-160.617, 160.6154(3), 205.745, 209.160, 224.01-310(1), 234.321, 234.370, 243.710, 243.720, 243.730, 243.850, 243.884, 248.756(2), 299.530, 304.4-030, 304.11-050, 304.49-220, 351.175, 395.470(3), 413.120
STATUTORY AUTHORITY: KRS 131.130(3)
NECESSITY, FUNCTION, AND CONFORMITY: KRS 131.130(3) authorizes the Department of Revenue to prescribe forms necessary for the administration of any revenue law by the promulgation of an administrative regulation incorporating the forms by reference. This administrative regulation incorporates by reference the required Revenue Forms used in the general administration of taxes by the Department of Revenue and not limited to a specific tax.
Section 1. Administrative - Required Forms. (1) Revenue Form 10A001, "Request to Inspect Public Records", shall be completed by the public to request access to public records specified on the form.
(2) Revenue Form 10A020, "Waiver of Appeal Rights", shall be completed by a taxpayer to reopen an audit that has become final if the taxpayer has failed to timely file a protest with the Department of Revenue.
(3) Revenue Form 10A070, "Authorization Agreement for Electronic Funds Transfer", shall be completed by taxpayers to authorize the Department of Revenue to move funds by electronic means from taxpayer accounts to the Department of Revenue as payment for taxes.
(4) Revenue Form 10A071, "EFT Bank Change", shall be completed by taxpayers who are registered as EFT ACH Debit filers to notify the department of a bank account change.
(5) Revenue Form 10A100, "Kentucky Tax Registration Application", shall:
(a) Be used by taxpayers to voluntarily apply for tax registration of the following accounts:
1. Employer’s Kentucky withholding tax;
2. Corporation income tax;
3. Sales and use tax;
4. Consumer’s use tax;
5. Motor vehicle tire fee;
6. Transient room tax;
7. Limited liability entity tax;
8. Utility Gross Receipts License tax;
9. Telecommunications tax;
10. Coal severance and processing tax; or
11. Coal Seller/Purchaser Certificate ID Number; and
(b) Provide the department the necessary information to properly register the taxpayer for all applicable tax accounts, including the legal business name, federal employer identification number (FEIN), address and other demographic information for the business, and each responsible party’s information including full name, social security number, and residential address.
(6) Revenue Form 10A100-CS,
"Kentucky Tax Registration Application", shall:[;]
(a) Be sent by the department's Division of Registration and Data Integrity to non-compliant taxpayers for the taxpayers to apply for tax registration of the following accounts:
1. Employer's Kentucky withholding tax;
2. Corporation income tax;
3. Sales and use tax;
4. Consumer’s use tax;
5. Motor vehicle tire fee;
6. Transient room tax;
7. Limited liability entity tax;
8. Utility Gross Receipts License tax;
9. Telecommunications tax;
10. Coal severance and processing tax; or
11. Coal Seller/Purchaser Certificate ID Number; and
(b) Provide the department the necessary information to properly register the taxpayer for all applicable tax accounts, including the legal business name, federal employer identification number (FEIN), address and other demographic information for the business, and each responsible party’s information including full name, social security number, and residential address.
(7) Revenue Form 10A100-I, "Instructions, Kentucky Tax Registration Application", shall provide instructions for the proper completion of Revenue Form 10A100, "Kentucky Tax Registration Application", which is used to apply for employer's Kentucky withholding tax, corporation income tax, sales and use tax, consumer’s use tax, motor vehicle tire fee, transient room tax, limited liability entity tax, utility gross receipts license tax, telecommunications tax, coal severance and processing tax, or the coal seller/purchaser certificate ID number.
(8) Revenue Form 10A100-CS(I), "Instructions, Kentucky Tax Registration Application", shall provide instructions for the proper completion of Revenue Form 10A100-CS, "Kentucky Tax Registration Application", which is used to apply for employer's Kentucky withholding tax, corporation income tax, sales and use tax, consumer’s use tax, motor vehicle tire fee, transient room tax, limited liability entity tax, utility gross receipts license tax, telecommunications tax, coal severance and processing tax, or the coal seller/purchaser certificate ID number.
(9) Revenue Form 10A104, "Update or Cancellation of Kentucky Tax Account(s)", shall:
(a) Be used by the taxpayer to update business information or to cancel accounts for the following taxes:
1. Employer's Kentucky withholding tax;
2. Corporation income tax;
3. Sales and use tax;
4. Consumer’s use tax;
5. Motor vehicle tire fee;
6. Transient room tax;
7. Limited liability entity tax;
8. Utility Gross Receipts License tax;
9. Telecommunications tax; or
10. Coal severance and processing tax;
and[.]
(b) Provide[The update form
provides] the department the necessary
information to properly update and maintain demographic information of the
business for all applicable tax accounts, including the legal business name,
federal employer identification number (FEIN), address and other demographic
information for the business, and each responsible party’s information
including full name, social security number, and residential
address.
(10) Revenue Form 10A104-I, "Instructions Update or Cancellation of Kentucky Tax Account(s)", shall provide instructions for the proper completion of Revenue Form 10A104.
(11) Revenue Form 10A106, "Appointment of Taxpayer Administrator and Authorized Users for Kentucky Online Tax", shall be used to establish a taxpayer administrator and authorized users for use of the Kentucky Online Tax System.
(12) Revenue Form 10A2000, "Request for Return/Information", shall be used to request information from the disclosure office as an inter-agency request or as a request from an outside agency.
(13)[(12)] Revenue Form
10F060, "Electronic Funds Transfer Program: ACH Credit Guide", shall
provide information on the specific requirements of the Department of Revenue’s
Credit Method of tax remittance for the Electronic Funds Transfer Program.
(14)[(13)] Revenue Form
10F061, "Electronic Funds Transfer Program: Debit Guide", shall
provide instructions to the taxpayer on how to authorize the Department of
Revenue to electronically debit a taxpayer controlled account in an Automated
Clearing House participating financial institution for the amount which the
taxpayer reports to the state’s data collection service.
(15)[(14)] Revenue Form
10F100, "Your Rights As a Kentucky Taxpayer", shall provide the
public with information describing taxpayer rights provided by KRS Chapters
131, 133, and 134.
(16)[(15)] Revenue Form
12A012, "Receipt of Seized Property", shall be presented for
execution to the taxpayer receiving returned property from the Kentucky
Department of Revenue that was previously seized for failure to pay taxes in
order to establish documentation that the property was returned to the
taxpayer.
(17)[(16)] Revenue Form
12A018, "Kentucky Department of Revenue Offer in Settlement
Application", shall be presented for execution to persons requesting to
settle their tax liabilities for less than the delinquent tax liability based
upon doubt as to collectability or doubt as to liability.
(18)[(17)] Revenue Form
12A104, "Notice of Seizure", shall be presented to the owner or
officer of the entity from which the Kentucky Department of Revenue is seizing
property for failure to pay taxes owed to the Commonwealth.
(19)[(18)] Revenue Form
12A107, "Notice of Sale", shall be presented to the owner of seized
property, published in the newspaper with the highest circulation for that
area, and posted at the courthouse, at three (3) other public places within the
county, and where the seizure was made, for the purpose of notifying the
property owner, and advertising to the public the sale of the seized property.
(20)[(19)] Revenue Form
12A109-1, "Release of Bank Levy", shall be presented to the bank on
which the levy was served for the purpose of releasing the seized property.
(21)[(20)] Revenue Form
12A109-2, "Release of Levy", shall be presented to the party on which
the levy was served for the purpose of releasing the seized property.
(22)[(21)] Revenue Form
12A109-3, "Release of Levy", shall be presented to the party on which
the levy was served for the purpose of releasing the seized property related to
child support.
(23)[(22)] Revenue Form
12A110, "Release of Levy on Wages, Salary, and Other Income", shall
be presented to an employer for the purpose of releasing a wage levy.
(24)[(23)] Revenue Form
12A110-1, "Release of Levy on Wages, Salary, and Other Income", shall
be presented to an employer for the purpose of releasing a wage levy related to
child support.
(25)[(24)] Revenue Form
12A500, "Certificate of Partial Discharge of Tax Lien", shall be
presented to anyone who makes a proper application for a lien release on a
specific piece of property if the Department of Revenue's lien attaches no
equity or if the equity that the lien encumbers is paid to the Department of
Revenue.
(26)[(25)] Revenue Form
12A501, "Certificate of Subordination of Kentucky Finance and
Administration Tax Lien", shall be presented to anyone who makes proper
application requesting that the Department of Revenue subordinate its lien
position to a new mortgage and demonstrates that the subordination is in the
Commonwealth’s best interest.
(27)[(26)] Revenue Form
12A502, "Application for Certificate of Subordination of Kentucky Tax
Lien", shall be presented to anyone who requests to have the Department of
Revenue subordinate its lien position to a new mortgage.
(28)[(27)] Revenue Form
12A503, "Application for Specific Lien Release", shall be presented
to anyone who requests that the Department of Revenue release its tax lien so
that a specific piece of property can be sold.
(29)[(28)] Revenue Form
12A504, "Personal Assessment of Corporate Officer or LLC Manager",
shall be presented to a corporate officer for the purpose of establishing
responsibility of payment of trust taxes owed to the Commonwealth.
(30)[(29)] Revenue Form
12A505, "Waiver Extending Statutory Period of Assessment of Corporate
Officer or LLC Manager", shall be presented to the corporate officers or
LLC managers for the purpose of entering into a payment agreement to pay the
trust taxes owed to the Commonwealth, and the terms of the payment agreement
shall extend past the statutory period for assessing responsible corporate
officers or LLC managers.
(31)[(30)] Revenue Form
12A506, "Waiver Extending Statutory Period for Collection", shall be
presented to the taxpayer for the purpose of extending the period in which the
liability can be collected.
(32)[(31)] Revenue Form 12A507,
"Table for Figuring the Amount Exempt From Levy on Wages, Salary, and
Other Income", shall be presented to employers with a wage levy on an employee
for the purpose of calculating the dollar amount of wages due to the employee.
(33)[(32)] Revenue Form
12A508-1, "Notice of Tax Due", shall be presented for the purpose of
assessing an officer of a corporation who is personally liable for trust taxes
owed to the Commonwealth.
(34)[(33)] Revenue Form
12A508-2, "Notice of Tax Due", shall be presented for the purpose of
assessing an officer of a corporation who is personally liable for Gasoline and
Special Fuels taxes owed to the Commonwealth.
(35)[(34)] Revenue Form
12A508-3, "Notice of Tax Due", shall be presented for the purpose of
assessing a manager or partner of a limited liability company who is personally
liable for trust taxes owed to the Commonwealth.
(36)[(35)] Revenue Form
12A508-4, "Notice of Tax Due", shall be presented for the purpose of
assessing a manager or partner of a limited liability company who is personally
liable for Gasoline and Special Fuels taxes owed to the Commonwealth.
(37)[(36)] Revenue Form
12A514, "Questionnaire for Persons Relative to a Notice of Assessment",
shall be presented to an officer of a corporation for the purpose of resolving
responsibility of the trust taxes owed to the Commonwealth.
(38)[(37)] Revenue Form
12A517, "Notice of Lien", shall be presented to the county clerk for
appropriate recording and to the taxpayer against whom the lien is filed for
the purpose of filing and recording the tax lien in the county clerk’s office
and giving notification to the taxpayer.
(39)[(38)] Revenue Form
12A517-1, "Notice of Child Support Lien", shall be presented to the
county clerk for appropriate recording and to the taxpayer against whom the
lien is filed for the purpose of filing and recording the tax lien in the
county clerk’s office and giving notification to the taxpayer.
(40)[(39)] Revenue Form
12A518, "Certificate of Release of Lien", shall be presented to the
county clerk and to the taxpayer against whom the tax lien is filed for the
purpose of releasing the lien and notifying the taxpayer of the release.
(41)[(40)] Revenue Form
12A518-1, "Certificate of Release of Child Support Lien", shall be
presented to the county clerk and to the taxpayer against whom the child
support lien is filed for the purpose of releasing the lien and notifying the
obligor of the release.
(42)[(41)] Revenue Form
12A638, "Statement of Financial Condition for Individuals", shall be
presented to individuals requesting to make payments or settle their tax
liability to the Commonwealth for the purpose of establishing the financial
ability to make payments or settle.
(43)[(42)] Revenue Form
12A638(I), "Instructions for Completing Statement of Financial Condition
for Individuals", shall provide instructions for completing Revenue Form
12A638.
(44)[(43)] Revenue Form
12A639, "Statement of Financial Condition for Businesses", shall be
presented to business owners requesting to make payments or settle a tax
liability to the Commonwealth for the purpose of establishing the financial
ability to make payments or settle.
(45)[(44)] Revenue Form
12A639(I), "Instructions for Completing Statement of Financial Condition
for Businesses", shall provide instructions for completing Revenue Form
12A639.
(46)[(45)] Revenue Form
12B019, "Notice of Levy on Wages, Salary, and Other Income", shall be
presented to employers for the purpose of levying wages from an employee who
owes taxes to the Kentucky Department of Revenue.
(47)[(46)] Revenue Form
12B019-1, "Notice of Levy on Wages, Salary, and Other Income", shall
be presented to employers for the purpose of levying wages from an employee who
owes child support.
(48)[(47)] Revenue Form
12B020, "Notice of Levy", shall be presented to banks for the purpose
of levying bank accounts of taxpayers who owe taxes to the Kentucky Department
of Revenue.
(49)[(48)] Revenue Form
12B020-2, "Notice of Levy", shall be presented to banks for the
purpose of levying bank accounts of obligors who owe child support.
(50)[(49)] Revenue Form
21A020, "Request for Copy of Tax Refund Check", shall be completed
and submitted to the Department of Revenue in order to obtain a copy of a
cashed refund check.
(51)[(50)] Revenue Form
30A005, "Temporary Vendor’s Sales Tax Permit", shall be presented to
temporary and transient vendors who do not have a permanent place of business
for the purpose of remitting tax on a non-permit basis, as required by 103 KAR
25:060.
(52)[(51)] Revenue Form
30A006, "Temporary Vendor Sales and Use Tax Return/Processing
Document", shall be used to register temporary vendors who do business in
the Commonwealth of Kentucky.
(53)[(52)] Revenue Form
30A872, "Record of Money Receipt Issued", shall be used by Department
of Revenue Field personnel to provide written documentation of acceptance of
cash payments.
(54)[(53)] Revenue Form
31A001, "Vendor Contact Authorization", shall be used by a Department
of Revenue representative to obtain permission from a taxpayer to contact his or
her vendors concerning the issuance of exemption certificates.
(55)[(54)] Revenue Form
31A004, "Auditor Record of Money Receipt Issued", shall be used by
the auditor to acknowledge payment from taxpayers of taxes determined to be
tentatively due at the time of an audit.
(56)[(55)] Revenue Form
31A011-ASH, "Taxpayer Data Questionnaire", shall be used by auditors
at the Ashland Taxpayer Service Center to gather information regarding a
taxpayer's capability to provide electronic data as requested under KRS
131.240.
(57)[(56)] Revenue Form
31A011-BG, "Taxpayer Data Questionnaire", shall be used by auditors
at the Bowling Green Taxpayer Service Center to gather information regarding a
taxpayer's capability to provide electronic data as requested under KRS
131.240.
(58)[(57)] Revenue Form
31A011-CKY, "Taxpayer Data Questionnaire", shall be used by auditors
at the Central Kentucky Taxpayer Service Center to gather information regarding
a taxpayer's capability to provide electronic data as requested under KRS
131.240.
(59)[(58)] Revenue Form
31A011-COR, "Taxpayer Data Questionnaire", shall be used by auditors
at the Corbin Taxpayer Service Center to gather information regarding a
taxpayer's capability to provide electronic data as requested under KRS
131.240.
(60)[(59)] Revenue Form
31A011-HOP, "Taxpayer Data Questionnaire", shall be used by auditors
at the Hopkinsville Taxpayer Service Center to gather information regarding a
taxpayer's capability to provide electronic data as requested under KRS 131.240.
(61)[(60)] Revenue Form
31A011-LOU, "Taxpayer Data Questionnaire", shall be used by auditors
at the Louisville Taxpayer Service Center to gather information regarding a
taxpayer's capability to provide electronic data as requested under KRS 131.240.
(62)[(61)] Revenue Form
31A011-NKY, "Taxpayer Data Questionnaire", shall be used by auditors
at the Northern Kentucky Taxpayer Service Center to gather information
regarding a taxpayer's capability to provide electronic data as requested under
KRS 131.240.
(63)[(62)] Revenue Form
31A011-OWEN, "Taxpayer Data Questionnaire", shall be used by auditors
at the Owensboro Taxpayer Service Center to gather information regarding a
taxpayer's capability to provide electronic data as requested under KRS
131.240.
(64)[(63)] Revenue Form
31A011-PAD, "Taxpayer Data Questionnaire", shall be used by auditors
at the Paducah Taxpayer Service Center to gather information regarding a
taxpayer's capability to provide electronic data as requested under KRS
131.240.
(65)[(64)] Revenue Form
31A011-PIKE, "Taxpayer Data Questionnaire", shall be used by auditors
at the Pikeville Taxpayer Service Center to gather information regarding a
taxpayer's capability to provide electronic data as requested under KRS
131.240.
(66)[(65)] Revenue Form
31A012, "Interstate Sales/Income Tax Questionnaire", shall be used to
establish possible taxing jurisdiction for sales and use tax and income tax for
the states of Ohio and Indiana.
(67)[(66)] Revenue Form
31A014, "SEATA - Southeastern Association of Tax Administrators Nexus
Questionnaire", shall be used to establish possible taxing jurisdiction
for sales and use tax and income tax for the states of Alabama, Arkansas,
Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, Tennessee,
Virginia and West Virginia.
(68)[(67)] Revenue Form
31A020, "Office of Field Operations Request for Copy of Tax Return(s)",
shall be used by Department of Revenue representatives to obtain permission
from a taxpayer to release tax returns.
(69)[(68)] Revenue Form
31A050, "Electronic Transmittal Authorization", shall be used by
auditors to seek permission from a taxpayer to transmit audit results
electronically.
(70)[(69)] Revenue Form
31A115, "Agreement Fixing Test Periods", shall be used by auditors to
establish certain test periods when conducting an audit.
(71)[(70)] Revenue Form
31A149, "Agreement Fixing Period of Limitation Upon Assessment of Sales,
Use or Severance Tax", shall be completed by a taxpayer and a
representative of the Kentucky Department of Revenue whereby both parties
consent and agree that certain sales, use or severance tax deficiencies or
overpayments for specific periods may be assessed or refunded beyond the normal
four (4) year statute of limitations.
(72)[(71)] Revenue Form 31A150,
"Agreement Fixing Period of Limitation Upon Assessment of Utility Gross
Receipts License Tax", shall be used by auditors to establish taxable
periods to be held open for audit and date of assessment.
(73)[(72)] Revenue Form
31A685, "Authorization to Examine Bank Records", shall be used by the
Department of Revenue to obtain permission from a taxpayer to examine records
in connection with transactions at the taxpayer’s bank.
(74)[(73)] Revenue Form
31A725, "Statute of Limitations Agreement", shall be completed by a
taxpayer and a representative of the Kentucky Department of Revenue whereby
both parties consent and agree that certain income tax deficiencies or
overpayments for specific periods may be assessed or refunded beyond the normal
four (4) year statute of limitations.
(75)[(74)] Revenue Form
31F006, "Southeastern States Information Exchange Program", shall be
used to provide information to taxpayers concerning the information exchange
program between the states of Alabama, Arkansas, Florida, Georgia, Kentucky,
Louisiana, Mississippi, North Carolina, Tennessee, Virginia, and West Virginia.
(76)[(75)] Revenue Form
31F010, "Kentucky’s Computer Assisted Audit Program", shall be the
brochure used as instructions for taxpayers who submit tax records in an
electronic format.
Section 2. Incorporation by Reference. (1) The following material is incorporated by reference:
(a) Revenue Form 10A001, "Request to Inspect Public Records", February 1997;
(b) Revenue Form 10A020, "Waiver of Appeal Rights", January 2001;
(c) Revenue Form 10A070, "Authorization Agreement for Electronic Funds Transfer", January 2008;
(d) Revenue Form 10A071, "EFT Bank Change", June 2009;
(e) Revenue Form 10A100, "Kentucky
Tax Registration Application", October 2011; [July 2010;]
(f) Revenue Form 10A100-CS,
"Kentucky Tax Registration Application", October 2011; [July
2010;]
(g) Revenue Form 10A100-I,
"Instructions Kentucky Tax Registration Application", June 2011;
[July 2010;]
(h) Revenue Form 10A100-CS(I),
"Instructions Kentucky Tax Registration Application", June[January]
2011;[July 2010;]
(i) Revenue Form 10A104, "Update
or[of] Cancellation of Kentucky Tax Account(s)",
June 2011; [July 2010;]
(j) Revenue Form 10A104-I, "Instructions
Update or Cancellation of Kentucky Tax Account(s)", June 2011; [July
2010;]
(k) Revenue Form 10A106, "Appointment of Taxpayer Administrator and Authorized Users for Kentucky Online Tax", May 2010;
(l) Revenue Form 10A2000, "Request for Return/Information", October 2011;
(m)[(l)] Revenue Form
10F060, "Electronic Funds Transfer Program: ACH Credit Guide", April
2006;
(n)[(m)] Revenue Form
10F061, "Electronic Funds Transfer Program: Debit Guide", December
2008;
(o)[(n)] Revenue Form
10F100, "Your Rights as a Kentucky Taxpayer", October 2010;
(p)[(o)] Revenue Form
12A012, "Receipt of Seized Property", November 2006;
(q)[(p)] Revenue Form
12A018, "Kentucky Department of Revenue Offer in Settlement Application",
June 2011; [March 2009;]
(r)[(q)] Revenue Form
12A104, "Notice of Seizure", October 1982;
(s)[(r)] Revenue Form
12A107, "Notice of Sale", January 2000;
(t)[(s)] Revenue Form
12A109-1, "Release of Bank Levy", September 2004;
(u)[(t)] Revenue Form
12A109-2, "Release of Levy", January 2000;
(v)[(u)] Revenue Form
12A109-3, "Release of Levy", January 2008;
(w)[(v)] Revenue Form
12A110, "Release of Levy on Wages, Salary, and Other Income",
September 2004;
(x)[(w)] Revenue Form
12A110-1, "Release of Levy on Wages, Salary, and Other Income",
January 2008;
(y)[(x)] Revenue Form
12A500, "Certificate of Partial Discharge of Tax Lien", June 2006;
(z)[(y)] Revenue Form
12A501, "Certificate of Subordination of Kentucky Finance and Administration
Tax Lien", June 2006;
(aa)[(z)] Revenue Form
12A502, "Application for Certificate of Subordination of Kentucky Tax
Lien", October 2006;
(bb)[(aa)] Revenue Form
12A503, "Application for Specific Lien Release", October 2006;
(cc)[(bb)] Revenue Form
12A504, "Personal Assessment of Corporate Officer or LLC Manager",
June 2003;
(dd)[(cc)] Revenue Form 12A505,
"Waiver Extending Statutory Period of Assessment of Corporate Officer or
LLC Manager", June 2003;
(ee)[(dd)] Revenue Form
12A506, "Waiver Extending Statutory Period for Collection", June
2003;
(ff)[(ee)] Revenue Form
12A507, "Table for Figuring the Amount Exempt from Levy on Wages, Salary,
and Other Income", November 2006;
(gg)[(ff)] Revenue Form
12A508-1, "Notice of Tax Due", January 2008;
(hh)[(gg)] Revenue Form
12A508-2, "Notice of Tax Due", January 2008;
(ii)[(hh)] Revenue Form
12A508-3, "Notice of Tax Due", November 2008;
(jj)[(ii)] Revenue Form
12A508-4, "Notice of Tax Due", November 2008;
(kk)[(jj)] Revenue Form
12A514, "Questionnaire for Persons Relative to a Notice of Assessment",
August, 1996;
(ll)[(kk)] Revenue Form
12A517, "Notice of Lien", November 2011; [November 2008;]
(mm)[(ll)] Revenue Form
12A517-1, "Notice of Child Support Lien", November 2008;
(nn)[(mm)] Revenue Form
12A518, "Certificate of Release of Lien", November 2008;
(oo)[(nn)] Revenue Form
12A518-1, "Certificate of Release of Child Support Lien", January
2008;
(pp)[(oo)] Revenue Form
12A638, "Statement of Financial Condition for Individuals", July
2004;
(qq) Revenue Form 12A638(I), Instructions for Completing Statement of Financial Condition for Individuals", August 2004;
(rr)[(qq)][(pp)] Revenue
Form 12A639, "Statement of Financial Condition for Businesses", August
2004;
(ss)[(rr)][(qq)]
Revenue Form 12A639(I), "Instructions for Completing Statement of
Financial Condition for Businesses", August 2004;
(tt)[(rr)] Revenue
Form 12B019, "Notice of Levy on Wages, Salary, and Other Income",
September 2004;
(uu)[(ss)] Revenue
Form 12B019-1, "Notice of Levy on Wages, Salary, and Other Income", September
2011; [January 2008;]
(vv)[(tt)] Revenue
Form 12B020, "Notice of Levy", September 2004;
(ww)[(vv)][(uu)]
Revenue Form 12B020-2, "Notice of Levy", January 2008;
(xx)[(ww)][(vv)]
Revenue Form 21A020, "Request for Copy of Tax Refund Check", October
2006;
(yy)[(xx)][(ww)]
Revenue Form 30A005, "Temporary Vendor’s Sales Tax Permit", September
1998;
(zz)[(yy)][(xx)]
Revenue Form 30A006, "Temporary Vendor Sales and Use Tax Return/Processing
Document", December 2006;
(aaa)[(zz)][(yy)]
Revenue Form 30A872, "Record of Money Receipt Issued", October
2000[February 2008];
(bbb)[(aaa)][(zz)]
Revenue Form 31A001, "Vendor Contact Authorization", July 2006;
(ccc)[(bbb)][(aaa)]
Revenue Form 31A004, "Auditor Record of Money Receipt Issued", July
2006;
(ddd)[(ccc)][(bbb)]
Revenue Form 31A011-ASH, "Taxpayer Data Questionnaire", March 2009;
(eee)[(ddd)][(ccc)]
Revenue Form 31A011-BG, "Taxpayer Data Questionnaire", March 2009;
(fff)[(eee)][(ddd)]
Revenue Form 31A011-CKY, "Taxpayer Data Questionnaire", March 2009;
(ggg)[(fff)][(eee)]
Revenue Form 31A011-COR, "Taxpayer Data Questionnaire", March 2009;
(hhh)[(ggg)][(fff)]
Revenue Form 31A011-HOP, "Taxpayer Data Questionnaire", March 2009;
(iii)[(hhh)][(ggg)]
Revenue Form 31A011-LOU, "Taxpayer Data Questionnaire", March 2009;
(jjj)[(iii)][(hhh)]
Revenue Form 31A011-NKY, "Taxpayer Data Questionnaire", March 2009;
(kkk)[(jjj)][(iii)]
Revenue Form 31A011-OWEN, "Taxpayer Data Questionnaire", March 2009;
(lll)[(kkk)][(jjj)]
Revenue Form 31A011-PAD, "Taxpayer Data Questionnaire", March 2009;
(mmm)[(lll)][(kkk)]
Revenue Form 31A011-PIKE, "Taxpayer Data Questionnaire", March 2009;
(nnn)[(mmm)][(lll)]
Revenue Form 31A012, "Interstate Sales/Income Tax Questionnaire",
July 2006;
(ooo)[(nnn)][(mmm)]
Revenue Form 31A014, "SEATA - Southeastern Association of Tax Administrators
Nexus Questionnaire", July 2006;
(ppp)[(ooo)][(nnn)]
Revenue Form 31A020, "Office of Field Operations Request for Copy of Tax
Return(s)", July 2006;
(qqq)[(ppp)][(ooo)]
Revenue Form 31A050, "Electronic Transmittal Authorization", March
2011; [April 2008;]
(rrr)[(qqq)][(ppp)]
Revenue Form 31A115, "Agreement Fixing Test Periods", April 2008;
(sss)[(rrr)][(qqq)]
Revenue Form 31A149, "Agreement Fixing Period of Limitation Upon
Assessment of Sales, Use or Severance Tax", July 2006;
(ttt)[(sss)][(rrr)]
Revenue Form 31A150, "Agreement Fixing Period of Limitation Upon
Assessment of Utility Gross Receipts License Tax", May 2008;
(uuu)[(ttt)][(sss)]
Revenue Form 31A685, "Authorization to Examine Bank Records", May
1985;
(vvv)[(uuu)][(ttt)]
Revenue Form 31A725, "Statute of Limitations Agreement", July 2006;
(www)[(vvv)][(uuu)]
Revenue Form 31F006, "Southeastern States Information Exchange Program",
February 2005; and
(xxx)[(www)][(vvv)]
Revenue Form 31F010, "Kentucky’s Computer Assisted Audit Program", May
2010.
(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Department of Revenue, 501 High Street, Frankfort, Kentucky 40620, or at any Kentucky Department of Revenue Taxpayer Service Center, Monday through Friday, 8 a.m. to 5 p.m.
THOMAS B. MILLER, Commissioner
APPROVED BY AGENCY: February 7, 2012
FILED WITH LRC: February 8, 2012 at 4 p.m.
CONTACT PERSON: DeVon Hankins, Policy Advisor, Office of General Counsel, Finance and Administration Cabinet, 392 Capitol Annex, Frankfort, Kentucky 40601, phone (502) 564-6660, fax (502) 564-9875.