Kentucky Inheritance Tax Return - Short Form

Inheritance Tax Return - Short Form
Form 92A205
92A205 (6-16)
Commonwealth of Kentucky
DEPARTMENT OF REVENUE

Kentucky Inheritance
Tax Return
(Short Form)

FOR DEPARTMENT USE ONLY

	 
4   6	
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Account Number	
Tax	
Mo	
Year

This form is designed for small, uncomplicated estates. Requirements for use of
this return—This return may be used when (1) a federal estate tax return is not
required to be filed, (2) the assets of the estate consist of 10 items or less, (3) no
gifts or transfers were made within three years of death without full consideration,
(4) no real or personal property was transferred with a retained life interest, (5) the
decedent did not possess any power to appoint any real or personal property or
have the use of any qualified terminable interest property, and (6) the decedent had
not received any real or personal property from another decedent within five years
and paid inheritance tax on the property. Pursuant to KRS 140.190, the beneficiaries
as well as the personal representative(s) may be held personally liable for the tax.
	 Decedent’s Name	 Last	

First	

Occupation (If decedent was
	 Social Security Number		
retired at death, state occu			
pation prior to retirement.)
	
	 Residence (Domicile) at Time of Death

	

Number and Street	

	

Middle Initial	 Date of Death

Age at	
Death

Cause of Death	

City	

	 Name and Address of Executor/Administrator/Beneficiary	

State	

HR Code Number (if known)

ZIP Code	

County

Name and Address of Preparer

 Exec

 Atty

 Admr

 CPA

 _______

 _______

			

Return Status (check one):
  Original Return
  Amended Return—Refund
  Amended Return—Tax Due

Did the decedent have a will?   No   Yes  If Yes, attach a copy of the will.				
Did the decedent have a trust agreement?   No   Yes  If Yes, attach a copy of the trust agreement.			
Net Estate (from page 2)....................................................................................................................... 	$
Inheritance tax due from Section III on reverse side.......................................................................... 	$
Discount of 5% from tax if paid within 9 months from death............................................................ 	–
Total Tax Due ......................................................................................................................................... 	$
Interest and Penalty
  Interest for late payment (see general information)................................................................................	$
  Late filing penalty (see general information)............................................................................................	$
  Late payment penalty (see general information).....................................................................................	$
  Total due (tax plus interest and penalties, if applicable)..........................................................................	$
  Total previously paid...................................................................................................................................	$
  Balance due/Refund ...................................................................................................................................	$

 

✍

Attach check payable to “Kentucky State Treasurer” to this return and mail to
Kentucky Department of Revenue, Frankfort, KY 40620

Under criminal penalties, I declare that this return, including accompanying documents, has been examined by me, and
is, to the best of my knowledge and belief, true, correct and complete.

 (  )
	
	

Signature of Executor/Administrator/Beneficiary	

Social Security Number	

Date	

Telephone Number

E-mail Address of Executor/Administrator/Beneficiary

 (  )
	

Signature of Preparer	

Date	

Telephone Number	

E-mail Address

92A205 (6-16)

SECTION I—GROSS ESTATE

List all items which decedent owned or in which the decedent had an interest. Complete Form 92A204, Real Estate
Valuation Information Form, for each parcel of real estate. For stocks and bonds, a balance sheet, at a date nearest
the decedent’s death, together with a statement of net earnings and dividends paid for the five-year period
immediately preceding the date of death, must be supplied in support of these valuations (ex. financial institution’s
monthly statement.)
Ownership (Check or fill in applicable blocks)
Description and Location
of Real or Personal Property

Individual

Joint
Survivorship
REQUIRED
With

Without

Date
Placed in
Joint Names
REQUIRED

Name of
Co-Owner

Fair Cash
Value of 100%
Interest at
Date of Death

Decedent’s
Interest

TOTAL GROSS ESTATE ..................................................................................................................................................... 	$__________________________	

SECTION II—DEDUCTIONS
Funeral expenses....................................................................................	$_______________________________
Monument...............................................................................................	$_______________________________	
Cemetery lot and maintenance of lot....................................................	$_______________________________	
Subtotal (not to exceed $5,000)....................................................................................................................................... 	$__________________________	
Personal representatives’ commissions.......................................................................................................................... 	$__________________________
Attorneys’ fees................................................................................................................................................................... 	$__________________________
Appraisers’ fees and court costs...................................................................................................................................... 	$__________________________
Mortgages and liens (decedent’s share).......................................................................................................................... 	$__________________________
Other debts of decedent (itemize only if total debts exceed $500):
__________________________________________________________________________________________	 ........................... 	$__________________________
__________________________________________________________________________________________	 ........................... 	$__________________________
__________________________________________________________________________________________	 ........................... 	$__________________________
__________________________________________________________________________________________	 ........................... 	$__________________________
TOTAL DEDUCTIONS ........................................................................................................................................................ 	$__________________________
            NET

ESTATE (Total Gross Estate Less Total Deductions) (enter on page 1)............... 	$__________________________

Social Security
Number

Relationship
(If Any)
Age

Distributive Share

$	$	

Total Inheritance Tax Due (enter on page 1) ..................................................................................................................................................	 $

Total distributive shares (must equal net estate) ..............................................................................................	 $

	

List Names of Heirs and Beneficiaries or Exempt
Organizations. Itemize shares of property received.
(See General Information)

SECTION III—TAX COMPUTATION SCHEDULE
Tax

92A205 (6-16)