Tax Clearance - Special Event Request
Business Owner Information
    000-00-0000
   
 
   
    mm/dd/yyyy
   
 
   
    00000-0000
    000-000-0000
 
  000-000-0000
Business Information
  00-0000000
   
  if different than Business Name
   
   
     
 
    000-000-0000
 
  000-000-0000
 
     
 
  1000 characters or fewer.
Submission Verification and Agreement:
By checking this box, I declare under penalties of perjury that, to the best of my knowledge and belief, the above information is true and correct.  
By checking this box, approve the Kansas Department of Revenue to submit a copy of my tax clearance letter to the event named above.  
 

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