Form 42A815 PDF Details

The 42A815 form, an essential document created by the Commonwealth of Kentucky's Department of Revenue, serves a specific purpose for businesses seeking a withholding tax refund. This form requires detailed information from applicants, including the business's name, contact information, and the exact withholding tax account number associated with the Kentucky State Treasurer. Moreover, applicants must clearly state the period(s) during which the tax was reported and paid, alongside a thorough explanation for the refund request, which can span multiple sheets if necessary. Also noteworthy is the provision for those desiring an electronic fund transfer (EFT), mandating the submission of banking details such as the name of the bank, depositor account number, and routing transit number. Notably, the form emphasizes strict eligibility criteria, stipulating that only taxpayers who have made direct payments to the Kentucky State Treasurer may apply for a refund. Additionally, it outlines a statutory period, setting a four-year limit from the date of payment within which claims must be filed, beyond which requests will not be entertained. The completion and correctness of the application, as affirmed under the penalties of perjury by the signatory, are vital, including a declaration that the applicant has no outstanding tax liabilities to the Commonwealth of Kentucky. The directive to mail the completed form to the specified address in Frankfort, KY, encapsulates the procedural aspect of applying for a withholding tax refund, reflecting the form's significance in ensuring compliance and rectifying overpayments in withholding tax submissions.

QuestionAnswer
Form NameForm 42A815
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesherein, Kentucky, Routing, Depositor

Form Preview Example

42A815 (8-06)

Commonwealth of Kentucky

DEPARTMENT OF REVENUE

WITHHOLDING TAX

REFUND APPLICATION

Name of

 

 

 

 

 

 

(

)

 

Business

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter Exact Name as it Appears on Your Account (please print or type)

 

 

Telephone Number (include area code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

P.O. Box or Number and Street

City or Town

County

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

(1)

Withholding tax account number under which tax was paid to the Kentucky State Treasurer

 

 

 

 

___________________________________

 

 

 

 

 

 

(2)

Period(s) in which tax was reported and paid __________________________________________________

 

(3)

Explain the reason(s) for refund (attach separate sheet if necessary) _______________________________

 

 

 

_______________________________________________________________________________________

 

 

 

_______________________________________________________________________________________

 

 

 

_______________________________________________________________________________________

 

(4)

Amount of tax refund requested ____________________________________________________________

 

(5)

Banking Information (if electronic fund transfer (EFT) requested)

 

 

 

 

 

 

 

Name of Bank __________________________________________________________________________

 

 

 

Depositor Account Number (DAN) __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

 

 

 

 

 

 

 

 

 

Checking

 

 

 

Routing Transit Number (RTN) __ __ __ __ __ __ __ __ __

Account Type ➤

Savings

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

(1)

This application must be completed to receive the refund requested via EFT.

 

 

 

(2)

Only the taxpayer making payment of the tax directly to the Kentucky State Treasurer may file the application

 

 

 

for refund.

 

 

 

 

 

 

Instructions

(3)

Claims for refunds or credits must be filed within four years from the date the tax was paid to the State

 

 

 

 

Treasurer. After the statute of limitations has expired, no claims for refunds or credits will be considered.

 

(4)

Mail completed application to the Kentucky Department of Revenue, Withholding Tax Section, P.O. Box

 

 

 

181, Station 57, Frankfort, KY 40602-0181.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I, the undersigned, declare under the penalties of perjury that I have examined this refund application (including any attached schedules and statements) and to the best of my knowledge and belief, the statements contained herein are true, complete and correct, and that I am duly authorized to sign this application. The undersigned certifies that no tax liability of any kind is due or owing the Commonwealth of Kentucky by this applicant.

Signed

 

Title

Name

 

Date

(Print or Type)

Form 42A815 isn’t the one you’re looking for?

Related Documents