Form D-64 "Request for Copies of Reports and/or Bond" - Kansas

What Is Form D-64?

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, 2016;
  • 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;
  • Fill out the form in our online filing application.

Download a fillable version of Form D-64 by clicking the link below or browse more documents and templates provided by the Kansas Department of Revenue.

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Download Form D-64 "Request for Copies of Reports and/or Bond" - Kansas

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Kansas Department of Revenue
Request for Copies of Reports and/or Bond
www.ksrevenue.org
Requester Information:
Requester’s Name__________________________________________________________________
Organization (if applicable):__________________________________ Title_____________________
Address:________________________________________________ Phone:___________________
City:_______________________________________________ State:_____
Zip:______________
Dealership Information:
Dealership Name:_____________________________________ Dealer Number:_______________
Dealership Address:________________________________________________________________
City:__________________________________________________________ Zip:______________
Fee
Record(s) you are requesting:
Dealer Monthly Sales Report(s) From:__________ To:___________
$6.00 (per report)
Auction Monthly Sales Report(s) From:
__________
To:
___________
$25.00 (per report)
Dealer Bond
Effective as of (date):________________
$6.00 (per bond)
Total Amount Due:
$_________
Other (Provide description and see instructions for additional costs):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
I declare that I am eligible and have the expressed authority to sign for and receive the requested
information pursuant to the Kansas Open Records Act. I further declare that any personal information
I receive will not be used to sell or offer for sale any property or service.
Requester’s Signature:_________________________________________ Date:_______________
D-64 (Rev. 0416)
Kansas Department of Revenue
Request for Copies of Reports and/or Bond
www.ksrevenue.org
Requester Information:
Requester’s Name__________________________________________________________________
Organization (if applicable):__________________________________ Title_____________________
Address:________________________________________________ Phone:___________________
City:_______________________________________________ State:_____
Zip:______________
Dealership Information:
Dealership Name:_____________________________________ Dealer Number:_______________
Dealership Address:________________________________________________________________
City:__________________________________________________________ Zip:______________
Fee
Record(s) you are requesting:
Dealer Monthly Sales Report(s) From:__________ To:___________
$6.00 (per report)
Auction Monthly Sales Report(s) From:
__________
To:
___________
$25.00 (per report)
Dealer Bond
Effective as of (date):________________
$6.00 (per bond)
Total Amount Due:
$_________
Other (Provide description and see instructions for additional costs):
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
I declare that I am eligible and have the expressed authority to sign for and receive the requested
information pursuant to the Kansas Open Records Act. I further declare that any personal information
I receive will not be used to sell or offer for sale any property or service.
Requester’s Signature:_________________________________________ Date:_______________
D-64 (Rev. 0416)
Instructions
 Provide a completed copy of this form for each request.
The department will provide records upon a direct match. If you have not provided enough
information to establish a direct match, the department will contact you requesting additional
information.
You must have the right of access to order these forms. You may not use any list of names or
addresses from the records to sale any property or service to any person who resides at any
address listed.
Make check or money order payable to the Kansas Department of Revenue and submit the fee
along with this form to:
Kansas Department of Revenue
Dealer Licensing
P O Box 2369
Topeka KS 66601-2369
 No refunds will be issued for requests made in error or request for records not on file.
If you are making a request under “Other”, the following fees may apply and our office will
notify you of any additional costs. Please email your request to Dealers.Licensing@kdor.ks.gov.
Copies (per page)
$.25
Mail charge
Current postage rate
Faxed copy
$.25
Search charge (staff time per hour)
$25.00
Computer time (staff time per hour)
$60.00
D-64 (Rev. 0416)
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