Kansas Sales and Use Tax Refund Application

Sales and Use Tax Refund Application
Pub. KS-1220 Kansas Sales and Use Tax Refund Rev. 2-22
Sales & Use
Tax Refund
The Kansas Department of Revenue
provides refunds for individuals or businesses
that paid sales or use tax directly to the
Kansas Department of Revenue in error.
This publication provides answers to some
common questions about receiving a refund.
It also contains the applicable forms, along
with the line-by-line instructions needed to
complete them.
If you would like information about how
Kansas sales and use tax applies to your
business operations, obtain a copy of
Publication KS-1510, Kansas Sales and
Compensating Use Tax.

ksrevenue.gov

Pub KS-1220
(Rev. 2-22)

TABLE OF CONTENTS
Frequently Asked Questions (FAQS)...........................	2-3

Business or Retail Business Project
Hospital, School, Political Subdivision Project
U.S. Government Project
Utility Exemption
Project Exemption Certificate (PEC) Entity
Motor Vehicles, Boat, Mobile Home, Aircraft

Completing form ST-21 Sales and Use Tax Refund
Application.................................................................. 	 3-4

Penalties.......................................................................	4
Required Documentation..............................................	4-7

Form ST-21 Sales and Use Tax Refund Application
(PARTS A through D)............................................ 	8-9

Amended Returns
Bad Debt
Exemption Claims Based on Statutes
Manufacturing Machinery and Equipment
Consumed In Production
Ingredient or Component Part

Assignment of Right to Refund (PART E)................... 	10
Claimant/Consumer Affidavit (PART F)....................... 	11
Taxpayer Assistance...................................	 BACK COVER
additional information is needed beyond what is requested, KDOR
will contact you in writing.

FREQUENTLY ASKED
QUESTIONS

Will an Assignment of Right to Refund relieve me of
providing proof of tax paid to the retailer?

Who can apply for this refund?

No. You must still provide proof of tax paid to your vendor,
such as a copy of a canceled check or an electronic copy of your
accounts payable showing tax paid to vendor.

Any individual or business that paid sales or use tax directly to
the Kansas Department of Revenue (KDOR) that was not owed
and was paid in error, may apply to the Department for a refund. If
the tax was paid to a retailer, the refund should be requested from
that retailer. Certain exceptions allow KDOR to issue a refund
directly to an individual or business that paid tax to a retailer
(see Part E of Form ST-21, Assignment of Right to Refund). An
individual or business that paid a tax that is administered by the
Secretary of Revenue to a county treasurer may apply directly
to the KDOR for a refund of that tax.

How long to process my refund request?
KDOR will begin processing your refund request after the
application and all of the necessary documentation is received.
Processing the information may take up to 120 days.

How can I find out the status of my refund application?

Yes. You must file a complete sales and use tax refund claim
within three years from the date the tax was due from the retailer
to KDOR. There is a unique statute of limitations for refunds of
bad debts. See page 4.

You can check on the status of your refund by calling Audit
Services at 785-296-7108 or email at KDOR_Audit.Funds@
ks.gov. Be prepared to provide the following information: your
Social Security Number, your federal Employer Identification
Number (EIN), the tax type, the exact amount of refund requested,
and the date you mailed the request.

Is there a dollar limit on a refund request?

Will I be entitled to interest on my refund?

Is there a time limit to request a refund?

Not necessarily. After KDOR receives the application and ALL
supporting documentation, a refund will be issued within 120
days. If the refund process take more than 120 days, interest
will be computed from the date that KDOR received the final
documentation that completes the application. Kansas law deems
the date of receipt to be the postmark date on the package that
contains the documentation or the date of mailing as certified by
a private delivery company.

Yes. Refund applications submitted by a retailer to KDOR must
be for taxes that total $5 or more. Refund applications submitted
directly to the Department by a consumer or purchaser must be for
taxes that total $50 or more. Refund applications that do not meet
these statutory threshold amounts will not be reviewed by KDOR.

What if I’ve never filed a tax return in Kansas?
In order to receive a refund, you will need to complete IRS
Form W-9, and submit it with your refund request. The W-9 form
is available at: www.irs.gov

What should I do if my application is returned to me as
incomplete?

As a retailer may I take a credit on my return instead of
requesting a refund?
A retailer should not take a deduction or credit on his/her tax
return, except for taxes refunded on returned goods. Instead, the
retailer is required to submit a written refund application to KDOR.

Should I send documentation with the application?
Yes. In almost every case, documentation is required. Refer
to the specific line instructions for Form ST-21, that begin on
page 3. These instructions provide the most common reasons
for requesting a refund and list the documentation required. If

2

Incomplete applications will not be reviewed by KDOR. KDOR
will notify you in writing and list the additional documentation you
must provide to complete your refund application. You will have 60
days from the date of the written notice to submit the requested
documentation. If your refund application is still incomplete after
you submit additional documentation or for more than 60 days
from the date of the notice, the Department will return your
incomplete refund application. If this happens, you will be required
to file a new refund application for the refund in question and the
statute of limitations will continue to run until it is submitted with
complete documentation.

the request is prepared/filed by a 3rd party. ONLY an owner,
partner, company officer or 3rd party with a Power of Attorney
accompanying the request may sign the refund application.

However, if you believe that your refund application was
complete, you may request an informal conference to review the
Department of Revenue’s determination. The letter you receive from
the Department will explain how to request an informal conference.

PART B – CLAIMANT (CONSUMER)

May my CPA, attorney or consultant handle the refund
request?

Enter all requested information for the claimant in Part B.
Fields marked with an asterisk require an entry in order to
process the application.
KDOR requires authorization from the Claimant/Consumer
to allow a KDOR associate to discuss the refund request with
any employee of the company and not only the contact person
listed on the refund application. Mark the proper box to allow
or disallow the authorization.
A Power of Attorney form is still required documentation if
the request is prepared/filed by a 3rd party. ONLY an owner,
partner, company officer or 3rd party with a Power of Attorney
accompanying the request may sign the refund application.

Yes. However, you must complete and submit form DO-10
Power of Attorney, that gives the Kansas Department of Revenue
the authority to discuss confidential tax matters with your chosen
representative. If a Power of Attorney form is not included with your
refund request, all correspondence will be sent to you. The Power
of Attorney form is available on our website at: ksrevenue.gov

What if I owe KDOR money?

The Kansas Department of Revenue reserves the right to
apply refunds to any existing debts owed to the Department,
regardless of the tax type.

Where do I get additional copies of the forms?

PART C – REFUND INFORMATION

The forms discussed in this publication, along with many other
tax forms are available on our website at: ksrevenue.gov

Enter the amount of your refund request and mark the box
that applies to the refund type. You must provide the applicable
exemption certificates with this application.

Where do I send my refund application?

Mail your completed ST-21, Sales and Use Tax Refund
Application, along with all required documentation to:

PART D – REFUND REQUEST SCHEDULE

Complete Part D with the information on an electronic
schedule, using Excel formatting, if available. Part D must
include the following:

Kansas Department of Revenue
Audit Services Bureau / Sales Tax Refund
PO Box 3506
Topeka, KS 66601-3506

– Invoice Date. Enter the month, day, and year in
chronological order.
– Invoice Number.
– Vendor Name.
– Description of Item(s). Provide a complete, detailed
description of the invoiced item.
– Retail Price.
– Tax Paid.
– Account Code. This is the fixed asset or expense account
to which the item purchased is being coded in your
business chart of accounts.
– Reason for Exemption. Provide a complete, detailed
explanation for why the item is exempt and reference
the statute number that supports that reason. Additional
information is needed if the exemption is based on any
of the following reasons:
•	 Materials consumed in production. Describe how
the materials are consumed.
•	 Machinery and equipment. Describe how the
equipment is used in the manufacturing process
and list the fixed asset or expense account code
with account descriptions.
•	 Ingredient or component part. Describe how the
item becomes an ingredient or component part.

You may also email to: [email protected]

COMPLETING THE SALES TAX
REFUND APPLICATION
Follow the instructions in this section to complete an
accurate application for a sales or use tax refund.
Complete form ST-21 application and provide the
appropriate documentation to the retailer from whom you
made the purchase.
The consumer may file the refund request directly with the
Kansas Department of Revenue if the retailer is no longer in
business, insolvent, moved or is unable to act. Complete Part
F of Form ST-21 to verify the retailer’s status.
If you paid the tax directly to the Department of Revenue,
then you may submit the application without going through
the retailer. Include copies of your returns and supporting
documentation when mailing Form ST-21.

PART A – RETAILER (VENDOR)

Enter all requested information for the retailer in Part A.
Fields marked with an asterisk require an entry in order to
process the application.
Mark the box that applies to your refund source and indicate
whether the consumer received a refund or credit by marking
the “yes” or “no” box.
KDOR requires authorization from the Retailer/Vendor to
allow a KDOR associate to discuss the refund request with
any employee of the company and not only the contact person
listed on the refund application. Mark the proper box to allow
or disallow the authorization.
A Power of Attorney form is still required documentation if

PART E – ASSIGNMENT OF RIGHT TO
REFUND

The retailer completes Part E if the retailer elects not to
participate in the sales or use tax refund process.

PART F – CLAIMANT / CONSUMER
AFFIDAVIT

3

Complete Part F if the retailer refuses to participate in the
refund process and does not respond or cannot be located.
Pursuant to K.A.R. 92-19-49c, you must enclose a copy of
certified mail receipt(s). The certified mail receipt(s) must

contain the retailer’s current business address. NOTE: Please
ensure good faith requirements are met as indicated in the
Claimant/Consumer Affidavit, Part F.

Required Documentation:
1)	 Detailed explanation for the error or overpayment.
2)	 Explanation of how the refund amount is computed.
3)	 Copy of the original return(s) with backup detail to those returns
such as electronic copy of the sales tax payable account to verify
the tax was paid to Kansas. If filing ST-36, include Part III.
4)	 Copy of original source documents such as invoices, leases,
contracts, etc.
5)	 Copy of the customer payment history.
6)	 Copy of company policy for writing off bad debts and supporting
schedules showing how the bad debts are written off.
7)	 Copy of federal income tax return the bad debts were claimed
on with the schedule of bad debts written off on the federal
income tax return.

PENALTIES
Pursuant to K.S.A. 79-3615(j), a person applying to the
department for a refund of any tax imposed under the Kansas
retailers’ sales tax act that was not previously collected by
the retailer, or that the retailer has already refunded to such
person, shall be subject to a penalty of 50% of the amount
of any such tax sought to be refunded. No such penalty shall
be imposed against such person if the retailer collected the
tax but did not remit such tax to the Department of Revenue.

EXEMPTION CLAIMS BASED ON STATUTES

REQUIRED DOCUMENTATION

l.	 Manufacturing Machinery and Equipment
[K.S.A. 79-3606(kk)]

The following instructions list the most common reasons
for requesting a sales or use tax refund. Select your reason
from one of the listed categories. Each category lists the
information and documentation that is needed to process the
sales or use tax refund request you are submitting on Form
ST-21. Provide as much of the documentation as possible.
The documentation may be submitted via electronic media to
[email protected]. If more information is needed,
the Department of Revenue will contact you in writing.

Complete Parts A, B, C and D of Form ST-21. Part D contains
the following information and, if available, it must be submitted
in an electronic format.
•	 Invoice date (month, day and year in chronological order).
•	 Invoice number.
•	 Vendor name.
•	 A complete description of the invoiced item.
•	 Retail price of the invoiced item.
•	 Tax paid on the invoiced item.
•	 A complete explanation for why the item is exempt and the
supporting statute number. Also list the fixed asset or expense
account code with account descriptions.
•	 If the purchase is for the repair of manufacturing equipment
explain how the piece of equipment being repaired is used
in the manufacturing process.
•	 If the purchase is for manufacturing equipment explain
how the piece of equipment being purchased is used in the
manufacturing process.

IMPORTANT: The more detailed information that you can
provide, the more quickly we can process your request for
refund.

AMENDED RETURNS
Complete Parts A, B, C and D of Form ST-21.
Required Documentation:
1)	 Detailed explanation for the error or overpayment.
2)	 Copy of original invoices or other relevant documents
verifying the transaction(s).
3)	 Copy of the original return(s). If filing Form ST-36, include
Part III with backup detail to those returns such as an
electronic copy of the sales tax payable account to verify
the tax was paid to Kansas.
4)	 Copy of the amended return(s). If filing Form ST-36, include
Part III.
5)	 Explanation of how the refund amount is computed.
6)	 Proof the sales tax was refunded to the customer, such as
one of the following:
a)	Copy of front and back of canceled check refunding
customer‘s payment; or,
b)	copy of irrevocable credit memo that was issued to
customer.

CAUTION: A statement of usage that only references

Kansas statutes, Kansas administrative regulations, or only
provide a generic description such as “repair parts” shall be
deemed an insufficient explanation for the basis of a refund.

Required Documentation:
1)	 Copy of manufacturing machinery and equipment exemption
certificate.
2)	 Copy of the invoices.
3)	 Proof that tax was submitted to Kansas such as detail
schedules supporting the original return or an electronic
copy of the sales tax payable account to verify the tax was
paid to Kansas (if request is submitted by vendor).
4)	 Assignment of Rights (if tax was paid to the vendor and
consumer is seeking a refund directly from Kansas).
5)	 Proof tax was paid (if request is submitted by consumer):
a)	 Copy of front and back of canceled check to vendor or,
b)	 electronic copy of accounts payable showing tax paid to
vendor and,
c)	 Self-assessed tax – Proof that tax was remitted to the
State, such as tax accrual schedules supporting the
taxpayer’s return. Provide accrual detail from the tax
account period where the tax was originally reported
up to the refund request submission date to the Kansas
Department of Revenue. This should include accrual
detail for each period within the refund request up to
and including present accruals (electronic copy must be
provided, if available).
6)	 Proof the tax was refunded to the customer (if request is

BAD DEBT
When filing a refund request for bad debt, please follow the
guidelines as written in K.A.R. 92-19-3b.
Complete Parts A, B, C and D of Form ST-21. Part D
contains the following information and, if available, it must be
submitted in an electronic format.
•	 Invoice date (month, day and year in chronological order).
•	 Invoice number.
•	 Vendor name.
•	 Retail price of the invoiced item.
•	 Tax paid on the invoiced item.
4

contains the following information and, if available, it must be
submitted in an electronic format.

submitted by vendor) such as one of the following:
a)	Copy of front and back of canceled check refunding
customer‘s payment; or,
b)	copy of irrevocable credit memo that was issued to
customer.

•	 Invoice date (month, day and year in chronological order).
•	 Invoice number.
•	 Vendor name.
•	 A complete description of the invoiced item.
•	 Retail price of the invoiced item.
•	 Tax paid on the invoiced item.
•	 A complete explanation for why the item is exempt and the
supporting statute number. Also list the fixed asset or expense
account code with account descriptions.
•	 For items becoming an ingredient or component part, you
must provide a description of the item purchased and a
factual description of how the item is becoming an ingredient
or component part.

The more detailed information that you can provide, the
more quickly we can process your request for refund.

II.	 Consumed in Production [K.S.A. 79-3606(n)]
Complete Parts A, B, C and D of Form ST-21. Part D
contains the following information and, if available, it must be
submitted in an electronic format.
•	 Invoice date (month, day and year in chronological order).
•	 Invoice number.
•	 Vendor name.
•	 A complete description of the invoiced item.
•	 Retail price of the invoiced item.
•	 Tax paid on the invoiced item.
•	 A complete explanation for why the item is exempt and the
supporting statute number. Also list the fixed asset or expense
account code with account descriptions.
•	 For items being consumed in the production process, you
must provide a description of the item purchased and a factual
description of how the item is consumed in the production
process.

CAUTION: A statement of usage that only references
Kansas statutes, Kansas administrative regulations, or
only provide a generic description such as “ingredient or
component part” shall be deemed an insufficient explanation
for the basis of a refund.
Required Documentation:
1)	 Copy of ingredient or component part exemption certificate.
2)	 Copy of the invoices.
3)	 Proof that tax was paid to Kansas such as detail schedules
supporting the original return or an electronic copy of the
sales tax payable account to verify the tax was paid to
Kansas (if request is submitted by vendor).
4)	 Assignment of Rights (if tax was paid to the vendor and the
consumer is seeking a refund directly from Kansas).
5)	 Proof tax was paid (if request is submitted by consumer):
a)	 Copy of front and back of canceled check to vendor or,
b)	 electronic copy of accounts payable showing tax paid to
vendor and,
c)	 Self-assessed tax – Proof that tax was remitted to the
State, such as tax accrual schedules supporting the
taxpayer’s return. Provide accrual detail from the tax
account period where the tax was originally reported
up to the refund request submission date to the Kansas
Department of Revenue. This should include accrual
detail for each period within the refund request up to
and including present accruals (electronic copy must be
provided, if available).
6)	 Proof the tax was refunded to the customer (if request is
submitted by vendor) such as one of the following:
a)	Copy of front and back of canceled check refunding
customer‘s payment; or,
b)	copy of irrevocable credit memo that was issued to
customer.

CAUTION: A statement of usage that only references
Kansas statutes, Kansas administrative regulations, or only
provide a generic description such as “supplies consumed
in production” shall be deemed an insufficient explanation
for the basis of a refund.
Required Documentation:
1)	 Copy of consumed in production exemption certificate.
2)	 Copy of the invoices.
3)	 Proof that tax was paid to Kansas such as detail schedules
supporting the original return or an electronic copy of the
sales tax payable account to verify the tax was paid to
Kansas (if request is submitted by vendor).
4)	 Assignment of Rights (if tax was paid to the vendor and the
consumer is seeking a refund directly from Kansas).
5)	 Proof tax was paid (if request is submitted by consumer):
a)	 Copy of front and back of canceled check to vendor or,
b)	 electronic copy of accounts payable showing tax paid to
vendor and,
c)	 Self-assessed tax – Proof that tax was remitted to the
State, such as tax accrual schedules supporting the
taxpayer’s return. Provide accrual detail from the tax
account period where the tax was originally reported
up to the refund request submission date to the Kansas
Department of Revenue. This should include accrual
detail for each period within the refund request up to
and including present accruals (electronic copy must be
provided, if available).
6)	 Proof the tax was refunded to the customer (if request is
submitted by vendor) such as one of the following:
a)	Copy of front and back of canceled check refunding
customer‘s payment; or,
b)	copy of irrevocable credit memo that was issued to
customer.

IV. Business or Retail Business Project
[K.S.A. 79-3606(cc) or K.S.A. 79-3606(hhhh)]

Complete Parts A, B, C and D of Form ST-21. Part D
contains the following information and, if available, it must be
submitted in an electronic format.
•	 Invoice date (month, day and year in chronological order).
•	 Invoice number.
•	 Vendor name.
•	 A complete description of the invoiced item.
•	 Retail price of the invoiced item.
•	 Tax paid on the invoiced item.
•	 A complete explanation for why the item is exempt and the
supporting statute number.

The more detailed information that you can provide, the
more quickly we can process your request for refund.

III.	Ingredient or Component Part [K.S.A. 79-3606(m)]
Complete Parts A, B, C and D of Form ST-21. Part D
5

All purchases must be for the facility to be eligible for
exemption and may not leave this facility.

Required Documentation:

c)	 Self-assessed tax – Proof that tax was remitted to the
State, such as tax accrual schedules supporting the
taxpayer’s return. Provide accrual detail from the tax
account period where the tax was originally reported
up to the refund request submission date to the Kansas
Department of Revenue. This should include accrual
detail for each period within the refund request up to
and including present accruals (electronic copy must be
provided, if available).
6)	 Proof the tax was refunded to the customer (if request is
submitted by vendor) such as one of the following:
a)	Copy of front and back of canceled check refunding
customer‘s payment; or,
b)	Copy of irrevocable credit memo that was issued to
customer.

1)	 Qualified firms under HPIP must provide a copy of the
Kansas Department of Commerce certification letter and
the project description pre-identifying this investment as well
as any backup documentation provided to the Department
of Commerce.
2)	 Description of business activity conducted at the business
facility and the claimant’s NAICS (North American
Industry Classification System) code.
3)	 Project beginning and ending dates.
4)	 Copy of the invoices, including any sub-contractor invoices
related to the project. You must use the ST-21PEC if you
are requesting a refund for tax your subcontractors
paid for materials incorporated into your project.
5)	 Proof that tax was paid to Kansas such as detail schedules
supporting the original return or an electronic copy of the
sales tax payable account to verify the tax was paid to
Kansas (if request is submitted by vendor).
6)	 Assignment of Rights (if tax was paid to the vendor and
consumer is seeking refund directly from Kansas).
7)	 Proof the tax was paid:
a)	 Copy of front and back of canceled check to vendor or,
b)	 Electronic copy of accounts payable showing tax paid to
vendor and,
c)	 Self-assessed tax – Proof that tax was remitted to the
State, such as tax accrual schedules supporting the
taxpayer’s return. Provide accrual detail from the tax
account period where the tax was originally reported
up to the refund request submission date to the Kansas
Department of Revenue. This should include accrual
detail for each period within the refund request up to
and including present accruals (electronic copy must be
provided, if available).
8)	 Proof the tax was refunded to the customer (if request is
submitted by vendor) such as one of the following:
a)	 Copy of front and back of canceled check refunding
customer‘s payment; or,
b)	 Copy of irrevocable credit memo that was issued to
customer.

VI.	U.S. Government Project [K.S.A. 79-3606(e)]
Complete Parts A, B, C and D of Form ST-21. Part D contains
the following information and, if available, it must be submitted
in an electronic format.
•	 	Invoice date (month, day and year in chronological order).
•	 	Invoice number.
•	 	Vendor name.
•	 	A complete description of the invoiced item.
•	 	Retail price of the invoiced item.
•	 	Tax paid on the invoiced item.
•	 	A complete explanation for why the item is exempt and the
supporting statute number.

Required Documentation:
1)	 Copy of valid project exemption certificate.
2)	 Copy of invoices.
3)	 Proof that tax was paid to Kansas such as detail schedules
supporting the original return or an electronic copy of the
sales tax payable account to verify the tax was paid to
Kansas (if request is submitted by vendor).
4)	 Assignment of Rights (if tax was paid to the vendor and
consumer is seeking refund directly from Kansas).
5)	 Proof tax was paid (if request is submitted by consumer):
a)	 Copy of front and back of canceled check to vendor or,
b)	 electronic copy of accounts payable showing tax paid to
vendor and,
c)	 Self-assessed tax – Proof that tax was remitted to the
State, such as tax accrual schedules supporting the
taxpayer’s return. Provide accrual detail from the tax
account period where the tax was originally reported
up to the refund request submission date to the Kansas
Department of Revenue. This should include accrual
detail for each period within the refund request up to
and including present accruals (electronic copy must be
provided, if available).
6)	 Proof the tax was refunded to the customer (if request is
submitted by vendor) such as one of the following:
a)	Copy of front and back of canceled check refunding
customer‘s payment; or,
b)	Copy of irrevocable credit memo that was issued to
customer.

V.	 Hospital, School, Political Subdivision
Project [K.S.A. 79-3606(d)]
Complete Parts A, B, C and D of Form ST-21. Part D
contains the following information and, if available, it must be
submitted in an electronic format.
•	
•	
•	
•	
•	
•	
•	

Invoice date (month, day and year in chronological order).
Invoice number.
Vendor name.
A complete description of the invoiced item.
Retail price of the invoiced item.
Tax paid on the invoiced item.
A complete explanation for why the item is exempt and the
supporting statute number.

Required Documentation:
1)	 Copy of valid project exemption certificate.
2)	 Copy of invoices.
3)	 Proof that tax was paid to Kansas such as detail schedules
supporting the original return or an electronic copy of the
sales tax payable account to verify the tax was paid to
Kansas (if request is submitted by vendor).
4)	 Assignment of Rights (if tax was paid to the vendor and
consumer is seeking refund directly from Kansas).
5)	 Proof tax was paid (if request is submitted by consumer):
a)	 Copy of front and back of canceled check to vendor or,
b)	 electronic copy of accounts payable showing tax paid to
vendor and,

UTILITY EXEMPTION
Complete Form ST-28B. The more detailed information
that you can provide, the more quickly we can process your
request for refund.
Required Documentation:

6

1)	 Formulas and computations must be completed and a copy of
your worksheet (utility study) must accompany your request.
Your worksheet (utility study) must list all taxable and nontaxable equipment that pulls energy from the meter for which

Tax was paid to another state.

you are seeking the sales tax exemption. The study must
include for each device it’s quantity, energy ratings, hours
per day used, days per year used, load factors, area of the
facility the device is located, and taxable or exempt status.
Hotels, motels, and nursing homes must also include the
facilities occupancy rate for the prior calendar year or the
most recent 12 months.
2)	 Form ST-33 must be completed by the utility provider.
3)	 Nursing homes and other entities that have both commercial
and residential areas may use the square foot method in
lieu of a complete study as listed in #1 above. The square
foot method must include resident’s room dimensions, total
square footage of the facility or include a floor plan that
includes room dimensions and occupancy rate for the prior
calendar year or the most recent 12 months. The square
foot method for calculating exemptions may only be utilized
for these type of residential* entities. For water exemption
requests the square foot of the landscape surrounding the
facility must also be included.

a)	 Proof of tax legally imposed and paid to another state.
b)	 Copy of Bill of Sale or invoice.

Vehicle was returned to the seller or repossessed.
a)	 Proof of buyback - canceled check, invoice (TR-312)
or signed and dated Affidavit.
b)	 Repossession Affidavit (TR-84), lien holder
information.

Taxpayer is exempt from paying tax.
a)	 Exemption Certificate.
b)	 Copy of Kansas sales tax receipt from County
Treasurer or Form ST-8 given to you by the dealer.

Trade-in or dealer discount, in house rebate or
dealer was not deducted.
a)	 Copy of bill of sale or invoice.
b)	 Copy of Kansas sales tax receipt from County
Treasurer.
c)	 For isolated sale, completed (TR-312) form.

*	Residential does not include hotels, motels and other similar
businesses. These types of businesses must furnish a utility study
which lists all taxable and non-taxable equipment.

Non-taxable title transfer

4)	 If the meter for the utility exemption you are requesting is
used for other than your exemption request, you must also
provide all the other uses for that meter.
5)	 Include your federal Employer Identification Number (EIN)
on your request.

a)	 Description of type of exempt title transfer.
b)	 Proof of exempt transfer.
•	 Affidavit of Fact (TR-12) stating the property was
received as a gift, etc.
•	 Relationship affidavit (TR-215), if applicable.
•	 Court documents showing divorce settlement.
•	 Proof of 100% corporation transfer.

PROJECT EXEMPTION CERTIFICATE (PEC)
ENTITY

K.A.R. 92-19-66e(n) provides that a PEC entity that fails
to secure a timely PEC for a construction project may seek
a refund of the Kansas sales tax that was paid or remitted
by the project’s general contractor and subcontractors on
their materials, supplies, and labor charges for the project in
question. To apply for a refund, complete and submit Form
ST-21PEC. This form is available at: ksrevenue.gov

Boats, Jet Ski, Aircraft
a)	 Proof of Isolated or Occasional Sale if you have
purchased a previously owned boat, jet ski or aircraft
(TR-312).
b)	 Copy of sales tax receipt from County Treasurer.

Lemon Law
a)	 Legible copy of the Bill of Sale, purchase order, or
buyer’s order.
b)	 Copy of buyback letter from vehicle manufacturer.
c)	 Copy of the check issued to customer for vehicle
buyback.
d)	 Receipt of vehicle mileage when returned to
dealership, if one was issued.
e)	 Copy of usage itemization provided by vehicle
manufacturer, if one was issued.

MOTOR VEHICLE, BOAT, MOBILE HOME,
AIRCRAFT

Complete Parts A, B, C and D of Form ST-21. The more
detailed information that you can provide, the more quickly
we can process your request for refund.
Required Documentation:
1)	 Copy of Bill of Sale, invoice or copy of title showing vehicle
transfer from original owner to you.
2)	 Copy of the Kansas sales tax receipt given to you by the
County Treasurer when you registered your vehicle.
3)	 Detailed explanation of why you are requesting a refund
(Part D of Form ST-21).

Dealer to Dealer transaction
a)	 Copy of Bill of Sale.
b)	 Vehicle must be sold or transferred within 15 days of
registration.

7

KANSAS	
SALES AND USE TAX REFUND APPLICATION

465001

Complete this application using the instructions that begin on page 3. Entries are required on all fields marked with an asterisk (*).
An incomplete application and missing documentation will delay the processing of your refund.

PART A - RETAILER (VENDOR)
*Business Name	

*Employer ID Number (EIN)

*Business Address	

*Kansas Tax Account Number

*City, State, Zip Code	

Previous Kansas Tax Account Number

*Contact Person	

*Telephone Number

Email Address	

Fax Number

	
No	 Yes	

Retailer/Vendor authorizes KDOR to discuss this refund request with any employee of the company and not only the contact
person listed above which prepared the request. A DO-10 (POA) is still required documentation if the request is prepared/filed by a 3rd party.

 Retailer filing for tax they paid	
 Retailer filing for tax paid by their customer
 Consumer filing for tax paid to a vendor	
 Consumer filing for tax paid directly to the state
Did the consumer receive a refund or credit?	  No	  Yes	 If yes, enclose a copy of the credit or cancelled check.
Source of refund:	

PART B - CLAIMANT (CONSUMER)
*Claimant Name	

*Employer ID Number (EIN) or Social Security Number (SSN)

*Claimant Address
*City, State, Zip Code
*Contact Person	

*Daytime Phone Number

Email Address	

Fax Number

	

	

No	
Yes	 Claimant/Consumer authorizes KDOR to discuss this refund request with any employee of the company and not only the contact
person listed above which prepared the request. A DO-10 (POA) is still required documentation if the request is prepared/filed by a 3rd party.

PART C - REFUND INFORMATION
Total Refund Request: $	

Refund Request Period(s):

Check the refund type and provide applicable exemption certificates (see instructions beginning on page 4):

 Manufacturing Machinery & Equipment, K.S.A.79-3606(kk) pg 4	
 Consumed in Production, K.S.A.79-3606(n) pg 5	
 Ingredient or Component Part, K.S.A.79-3606(m) pg 5	
 Business or Retail Business Project, K.S.A.79-3606(cc) or	
79-3606(hhhh) pg 5	

	 Hospital, School, Political Subdivision Project, K.S.A. 79-3606(d) pg 6
	 U.S. Government Project, K.S.A.79-3606(e) pg 6
	 Motor Vehicle Refund pg 7
	 Other (please explain)
_______________________________________________________________

_______________________________________________________________________________________________

You are required to complete Part D (page 9). Retailer should complete Part E (page 10).
If the retailer does not respond, the claimant will need to complete Part F (page 11).
I declare under penalties of perjury that to the best of my knowledge this is a true, correct, and complete application.
__________________________________________________________________________________________________________

Signature of Retailer (ONLY owner, partner, company officer or POA)	

Date

__________________________________________________________________________________________________________

Signature of Claimant (ONLY owner, partner, company officer or POA)	

ST-21 (Rev. 6-20)

Date

8









No	
Yes	 I agree to accept all written notices sent by the Department
electronically, in lieu of written notice sent first class mail, and waive any objection
to the legal sufficiency of any such notice because it was sent electronically.
No	
Yes	 I agree to accept all written notices sent by the Department
electronically, in lieu of written notice sent first class mail, and waive any objection
to the legal sufficiency of any such notice because it was sent electronically.

Invoice
Date

Invoice
Number

Vendor Name on Invoice

Description of Item(s)

Retail Price

Tax Paid

Reason for Exemption *

465002

TOTAL REFUND REQUESTED

Account
Code

PART D - REFUND REQUEST SCHEDULE (If additional lines are needed, make copies of this schedule. Provide it electronically if available).

* For requests under K.S.A. 79-3606(kk), K.S.A. 79-3606(m), or K.S.A. 79-3606(n) you must include a factual statement of usage
along with exemption reason.

9

465003
465003

PART E - ASSIGNMENT
ASSIGNMENT OF
OF RIGHT
RIGHT TO
TO REFUND
REFUND	

ASSIGNMENT OF RIGHT TO REFUND
Pursuant to K.S.A. 79-3650(a)(4)

Retailer assignment of right to allow purchaser/consumer to file refund request directly with the Kansas Department of Revenue.
(1) My name is_________________________________________________________________ , and I am a duly authorized representative of_____________________________________________
_______________________________________________________________________________________________

(the “Assignor/Retailer”). By executing this Assignment of Right to a

Refund (“Assignment”), the Assignor/Retailer assigns all rights and interest to the tax refund herein described that the Assignor/Retailer
may have to____________________________________________________________________________ (the “Assignee/Consumer”), subject to the limitation noted herein. The
Assignee’s/Consumer’s federal Employer Identification Number (EIN) is__________________________________________________________________ .
(2) The tax refund that is subject of this Assignment is described as follows:
Tax Type:____________________________________________________________ 	Period(s):____________________________________________________________________________________________________
Requested Amount:_____________________________________________
Transactions:_________________________________________________________________________________________________________________________________ (Attach schedule if necessary)
Please explain other specific limitations:_______________________________________________________________________________________________________________________________________
(3) The Assignor/Retailer agrees to provide to the Assignee/Consumer any information or documentation in their possession needed for
submission to the Kansas Department of Revenue to support or prove the refund request. Assignor/Retailer waives confidentiality to the
extent necessary for the Kansas Department of Revenue to verify the tax sought to be refunded was remitted to the Kansas Department
of Revenue.
(4) By executing this Assignment, the Assignor/Retailer affirms that the Assignor/Retailer remitted the tax sought to be refunded and has
neither previously claimed a refund nor taken a credit on a return for taxes that are subject of this Assignment, and further affirms that
the Assignor/Retailer will not claim a refund or a credit for those taxes in the future in accordance with K.S.A. 79-3615(j).
(5) The Assignor/Retailer understands the Assignor/Retailer shall be subject to the penalties of K.S.A. 79-3615(h) for any false information
provided in this statement. [$500 to $10,000 fine and one to six months imprisonment]
________________________________________________________________________________________ 	

____________________________________________

________________________________________________________________________________________ 	

____________________________________________

________________________________________________________________________________________ 	

____________________________________________

________________________________________________________________________________________ 	

____________________________________________

Assignor/Retailer Entity Name	

Print or type the name of the person authorizing assignment	

Signature of person authorizing assignment	

Email address	

Tax Account Number

Relationship to Entity

Date

Phone Number

I certify under penalties of perjury that, to the best of my knowledge, all of the information and statements made in this Assignment of Right
to Refund are true and correct.
STATE OF KANSAS	

)
) SS:
COUNTY OF_________________________________________________________ 	)
This Assignment of Right to Refund was acknowledged before me on_________________________________________________________________________ , 20_________________ by
_______________________________________________________________________________________________________

as _________________________________________________________________________________________ .

Name of Assignor/Retailer and Official Capacity (officer, superintendent, business manager, etc.)

Notary Public:___________________________________________________________________________
My appointment expires:_____________________________________________
10

465004

PART F - CLAIMANT / CONSUMER AFFIDAVIT	

AFFIDAVIT
This refund application is being submitted directly to the Kansas Department of Revenue without the participation
of _________________________________________________________ for the following reason:
(Retailer's Name)





The retailer is no longer in business.
The retailer has moved and the Consumer cannot locate the Retailer.
The Consumer attempted in good faith to obtain a refund from the Retailer and provides documentation that the
Retailer refused or is unable to refund the tax or did not act within 60 days of the date of the first refund request.
“Good Faith” means that the consumer provided the retailer with all of the documentation and information
needed to determine the validity of the refund request and has otherwise made a reasonable attempt to
obtain the refund from the retailer. This includes making a reasonable attempt to find the correct address of
the retailer. A mere request that a retailer agrees to allow the consumer to file a refund claim directly with
the department, without completing the Assignment of Right to Refund form, shall not constitute a good faith
attempt to obtain the refund from the retailer. (Retailers may be contacted.)

A copy of the certified letter and mail receipt to the retailer must be attached to the refund request.
On ________________________________________________________ the first refund request and required documents were sent to
(Date)

________________________________________________________

.

(Retailer's Name)

I certify under penalties of perjury that, to the best of my knowledge, all of the information and statements made in this Affidavit are true
and correct.

___________________________________________________________________________________________________________________________________ 	

(Claimant/Consumer’s Signature)	

________________________________________

(Date)

STATE OF KANSAS	

)
) SS:
COUNTY OF__________________________________________________________ )
SUBSCRIBED AND SWORN TO before me on_________________________________________________ , 20_____________ by ___________________________________________________________
Notary Public:___________________________________________________________________________

My appointment expires:_____________________________________________

11

TAXPAYER ASSISTANCE
This publication is a general guide and will not address every situation. If you have questions or need additional information,
please contact us at:
Phone: 785-296-7108
Fax: 785-296-0531
Email: [email protected]
If you wish to visit with someone in person, please call 785-296-7108 to set up an appointment.
Office hours are 8 a.m. to 4:45 p.m., Monday through Friday.

PUBLICATIONS
Below is a list of publications available on the Kansas Department of Revenue’s website. These publications contain
instructions applicable to specific business industries and general information for all business owners.
•
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•
•
•
•
•
•
•
•
•
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Publication KS-1216, Kansas Business Tax Application
Publication KS-1220, Kansas Sales and Use Tax Refund
Publication KS-1221PEC, Kansas Sales and Use Tax Refund (for use by PEC entities)
Publication KS-1510, Kansas Sales and Compensating Use Tax
Publication KS-1515, Kansas Tax Calendar of Due Dates
Publication KS-1520, Kansas Exemption Certificates
Publication KS-1525, Kansas Sales and Use Tax for Contractors, Subcontractors and Repairmen
Publication KS-1526, Kansas Business Taxes for Motor Vehicle Transactions
Publication KS-1527, Kansas Business Taxes for Political Subdivisions
Publication KS-1530, Kansas Tire Excise Tax
Publication KS-1540, Kansas Business Taxes for Hotels, Motels and Restaurants
Publication KS-1550, Kansas Business Taxes for Agricultural Industries
Publication KS-1560, Kansas Business Taxes for Schools and Educational Institutions
Publication KS-1700, Kansas Sales and Use Tax Jurisdiction Code Booklet
KW-100, Kansas Withholding Tax Guide

STATE SMALL BUSINESS WORKSHOPS
As part of our commitment to provide tax assistance to the business community, Tax Specialists within the Kansas Department
of Revenue conduct small business workshops on Kansas taxes at various locations throughout Kansas. Whether you are a
new business owner, an existing business owner, or an accountant, these workshops will give you the tools and understanding
necessary to make Kansas taxes easier and less time consuming for you. Topics covered include filing and reporting requirements
and methods, what is taxable, what is exempt and how to work with the department in collecting and remitting Kansas taxes.
For a schedule of our workshops, visit our website. Pre-registration is required and a fee may be charged by the sponsoring
Small Business Development Center (SBDC).