Form WP-4 "Irrevocable Election to Pay the Clean Drinking Water Fee" - Kansas

What Is Form WP-4?

This is a legal form that was released by the Kansas Department of Revenue - a government authority operating within Kansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2018;
  • The latest edition provided by the Kansas Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form WP-4 by clicking the link below or browse more documents and templates provided by the Kansas Department of Revenue.

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Download Form WP-4 "Irrevocable Election to Pay the Clean Drinking Water Fee" - Kansas

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NOTICE TO KANSAS DEPARTMENT OF REVENUE
IRREVOCABLE ELECTION TO PAY THE CLEAN DRINKING WATER FEE
The
_________________________________
Name of Public Water Supply System
Water Protection Fee Registration Number
Kansas Sales Tax Registration Number
irrevocably elects pursuant to 2004 Senate Bill 147, Section 11 to pay the Clean
Drinking Water Fee on retail sales of water beginning
January 1; April 1; July 1; or October 1 (check one) of
______
(enter year).
By making said election, the public water supply system understands that, as of the
date circled above, it will be exempt from all applicable Kansas Retailers' Sales or
Compensating Use taxes on its direct and indirect purchases of tangible personal
property and services used in the construction activities, operation or maintenance of
the district.
This election shall become effective on the above date only if the Department of
Revenue has received this document at least 30 days prior to such date.
Signature of Authorized Individual
Date
Title
Printed Name
Phone Number
MAIL OR FAX TO:
Miscellaneous Tax
Kansas Dept. of Revenue
PO Box 3506
Topeka, KS 66601-3506
Phone: 785-368-8222
Fax: 785-296-4993
WP-4
Rev. 4-18
NOTICE TO KANSAS DEPARTMENT OF REVENUE
IRREVOCABLE ELECTION TO PAY THE CLEAN DRINKING WATER FEE
The
_________________________________
Name of Public Water Supply System
Water Protection Fee Registration Number
Kansas Sales Tax Registration Number
irrevocably elects pursuant to 2004 Senate Bill 147, Section 11 to pay the Clean
Drinking Water Fee on retail sales of water beginning
January 1; April 1; July 1; or October 1 (check one) of
______
(enter year).
By making said election, the public water supply system understands that, as of the
date circled above, it will be exempt from all applicable Kansas Retailers' Sales or
Compensating Use taxes on its direct and indirect purchases of tangible personal
property and services used in the construction activities, operation or maintenance of
the district.
This election shall become effective on the above date only if the Department of
Revenue has received this document at least 30 days prior to such date.
Signature of Authorized Individual
Date
Title
Printed Name
Phone Number
MAIL OR FAX TO:
Miscellaneous Tax
Kansas Dept. of Revenue
PO Box 3506
Topeka, KS 66601-3506
Phone: 785-368-8222
Fax: 785-296-4993
WP-4
Rev. 4-18