Kansas Forms

For all state required compliance forms, please visit KHRC’s website.

Below are additional compliance forms provided by MHEG. If you have questions about what forms to use, please contact our Compliance Department for assistance at #402-334-8899.

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Kansas Forms

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Asset Worksheet 15.50 KB 1095 downloads

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Lump Sum Payment Certification 28.50 KB 1276 downloads

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Separation Certification 19.00 KB 1013 downloads

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Real Estate Asset Worksheet 126.44 KB 842 downloads

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Divorce Certification 19.00 KB 218 downloads

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Application 1-20-17 223.00 KB 247 downloads

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Recert Application 1-20-17 171.00 KB 201 downloads

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