"Waiver of Confidentiality Affidavit" - Kansas

Waiver of Confidentiality Affidavit is a legal document that was released by the Kansas Department of Revenue - a government authority operating within Kansas.

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WAIVER OF CONFIDENTIALITY
AFFIDAVIT
STATE OF KANSAS
)
) ss:
COUNTY OF __________ )
I,
the
undersigned,
hereby
state
and
attest
that
I
am
______________________(Name),
proprietor
of
the
business
known
as
_______________________________(Business Name), and that I have full knowledge
of the information regarding the __________________________(Tax Type) and any
other possible taxes involving _________________(Business Name). On the condition
that the secretary of the Kansas Department of Revenue abates all or part of the liability
associated with me or my associated business, and in order that I may comply with the
applicable provisions regarding the abatement of tax liability as set out in K.S.A. 1999
Supp. 79-3233a and 79-3618, I hereby waive any right and privilege regarding the
confidentiality of my taxes as afforded under the confidentiality provisions of Chapter 79
of the Kansas Statutes Annotated.
IN WITNESS WHEREOF, I have hereto affixed my signature at
_____
__ , Kansas, this ______ day of __________________________, 20____.
_____________________________
Name
DBA
SUBSCRIBED AND SWORN TO before me this _____ day of
_______________, 20____.
_____________________________
Notary Public
WAIVER OF CONFIDENTIALITY
AFFIDAVIT
STATE OF KANSAS
)
) ss:
COUNTY OF __________ )
I,
the
undersigned,
hereby
state
and
attest
that
I
am
______________________(Name),
proprietor
of
the
business
known
as
_______________________________(Business Name), and that I have full knowledge
of the information regarding the __________________________(Tax Type) and any
other possible taxes involving _________________(Business Name). On the condition
that the secretary of the Kansas Department of Revenue abates all or part of the liability
associated with me or my associated business, and in order that I may comply with the
applicable provisions regarding the abatement of tax liability as set out in K.S.A. 1999
Supp. 79-3233a and 79-3618, I hereby waive any right and privilege regarding the
confidentiality of my taxes as afforded under the confidentiality provisions of Chapter 79
of the Kansas Statutes Annotated.
IN WITNESS WHEREOF, I have hereto affixed my signature at
_____
__ , Kansas, this ______ day of __________________________, 20____.
_____________________________
Name
DBA
SUBSCRIBED AND SWORN TO before me this _____ day of
_______________, 20____.
_____________________________
Notary Public