Form 92a205 - Kentucky Inheritance Tax Return - 2015

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Kentucky Inheritance
92A205 (6-15)
FOR DEPARTMENT USE ONLY
Commonwealth of Kentucky
Tax Return
DEPARTMENT OF REVENUE
4 6
__ __ __ __ __ __ / __ __ / __ __ / __ __ __ __
Account Number
Tax
Mo
Year
(Short Form)
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,
Return Status (check one):
(4) no real or personal property was transferred with a retained life interest, (5) the
 Original Return
decedent did not possess any power to appoint any real or personal property or
 Amended Return—Refund
have the use of any qualified terminable interest property, and (6) the decedent had
 Amended Return—Tax Due
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
Middle Initial
Date of Death
Occupation (If decedent was
Social Security Number
Age at
Cause of Death
HR Code Number (if known)
retired at death, state occu-
Death
pation prior to retirement.)
Residence (Domicile) at Time of Death
Number and Street
City
State
ZIP Code
County
Name and Address of Executor/Administrator/Beneficiary
Name and Address of Preparer
Exec
Atty
 
 
Admr
CPA
 
 
_______
_______
Did the decedent have a will?
No
Yes If Yes, attach a copy of the will.
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

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