IRS Form 14135 "Application for Certificate of Discharge of Property From Federal Tax Lien"

What Is IRS Form 14135?

This is a tax form that was released by the Internal Revenue Service (IRS) - a subdivision of the U.S. Department of the Treasury on June 1, 2010. As of today, no separate filing guidelines for the form are provided by the IRS.

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Download IRS Form 14135 "Application for Certificate of Discharge of Property From Federal Tax Lien"

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Department of the Treasury — Internal Revenue Service
14135
Form
Application for Certificate of Discharge of
OMB No. 1545-2174
(June 2010)
Property from Federal Tax Lien
Complete the entire application. Enter NA (not applicable), when appropriate. Attachments and exhibits should be
included as necessary. Additional information may be requested of you or a third party to clarify the details of the
transaction(s).
:
1. Taxpayer Information
(Individual or Business named on the notice of lien)
Name
or
as it appears on lien
Primary Social Security Number
(Individual First, Middle Initial, Last)
(Business)
(last 4 digits only)
Name Continuation
or
Secondary Social Security Number
(Individual First, Middle Initial, Last)
(Business d/b/a)
(last 4 digits only)
Address
Employer Identification Number
(Number, Street, P.O. Box)
City
State
ZIP Code
Fax Number
Telephone Number
(with area code)
(with area code)
Check if also the Taxpayer
2. Applicant Information:
(If not the taxpayer, attach copy of lien. See Sec.10)
Name
Relationship to taxpayer
(First, Middle Initial, Last)
Address
(Number, Street, P.O. Box)
City
State
ZIP Code
Telephone Number
Fax Number
(with area code)
(with area code)
Check if also the Applicant
3. Purchase/Transferee/New Owner
Relationship to taxpayer
Attached: Form 8821 or
Yes
No
4. Attorney/Representative Information
Power of Attorney Form 2848
Name
Interest Represented
(First, Middle Initial, Last)
(e.g. taxpayer, lender, etc.)
Address
(Number, Street, P.O. Box)
State
City
ZIP Code
Telephone Number
Fax Number
(with area code)
(with area code)
5. Lender/Finance Company Information - or
(Settlement/Escrow Company for applications under Section 6325(b)(3) only)
Company Name
Contact Name
Contact Phone Number
www.irs.gov
Catalog Number 54727S
Form
14135
(Rev. 06-2010)
Department of the Treasury — Internal Revenue Service
14135
Form
Application for Certificate of Discharge of
OMB No. 1545-2174
(June 2010)
Property from Federal Tax Lien
Complete the entire application. Enter NA (not applicable), when appropriate. Attachments and exhibits should be
included as necessary. Additional information may be requested of you or a third party to clarify the details of the
transaction(s).
:
1. Taxpayer Information
(Individual or Business named on the notice of lien)
Name
or
as it appears on lien
Primary Social Security Number
(Individual First, Middle Initial, Last)
(Business)
(last 4 digits only)
Name Continuation
or
Secondary Social Security Number
(Individual First, Middle Initial, Last)
(Business d/b/a)
(last 4 digits only)
Address
Employer Identification Number
(Number, Street, P.O. Box)
City
State
ZIP Code
Fax Number
Telephone Number
(with area code)
(with area code)
Check if also the Taxpayer
2. Applicant Information:
(If not the taxpayer, attach copy of lien. See Sec.10)
Name
Relationship to taxpayer
(First, Middle Initial, Last)
Address
(Number, Street, P.O. Box)
City
State
ZIP Code
Telephone Number
Fax Number
(with area code)
(with area code)
Check if also the Applicant
3. Purchase/Transferee/New Owner
Relationship to taxpayer
Attached: Form 8821 or
Yes
No
4. Attorney/Representative Information
Power of Attorney Form 2848
Name
Interest Represented
(First, Middle Initial, Last)
(e.g. taxpayer, lender, etc.)
Address
(Number, Street, P.O. Box)
State
City
ZIP Code
Telephone Number
Fax Number
(with area code)
(with area code)
5. Lender/Finance Company Information - or
(Settlement/Escrow Company for applications under Section 6325(b)(3) only)
Company Name
Contact Name
Contact Phone Number
www.irs.gov
Catalog Number 54727S
Form
14135
(Rev. 06-2010)
Page 2 of 3
6. Monetary Information
Proposed sales price
Expected proceeds to be paid to the United States in exchange for
the certificate of discharge
(Enter NA if no proceeds are anticipated)
7. Basis for Discharge: Check the box below that best addresses what you would like the United States to consider in
your application for discharge.
(Publication 783 has additional descriptions of the Internal Revenue Code sections listed below.)
6325(b)(1)
Value of property remaining attached by the lien(s) is at least double the liability of the federal tax
lien(s) plus other encumbrances senior to the lien(s)
6325(b)(2)(A) The United States receives an amount not less than the value of the United States' interest.
(Note: If you are applying under 6325(b)(2)(A) and are the property owner but not the taxpayer, see also
section 16.)
6325(b)(2)(B) Interest of the United States in the property to be discharged has no value.
6325(b)(3)
Proceeds from property sale held in escrow subject to the liens and claims of the United States.
6325(b)(4)
Deposit made or bond furnished in an amount equal to the value of the United States' interest.
(Note: This selection provides a remedy under 7426(a)(4) for return of deposit but is exclusively for a property
owner not named as the taxpayer on the lien)
8. Description of property
(for example, 3 bedroom rental house; 2002 Cessna twin engine airplane, serial number
AT919000000000X00; etc.):
Address of real property
:
(If this is personal property, list the address where the property is located)
Address
(Number, Street, P.O. Box)
City
State
ZIP Code
FOR REAL ESTATE: a legible copy of the deed or title showing
Attached
NA
the legal description is required
FOR Discharge Requests under Section 6325(b)(1):
copy of deed(s) or title(s) for property remaining subject to the
Attached
NA
Federal Tax Lien is required
9. Appraisal and Valuations
REQUIRED APPRAISAL
Attached
Professional appraisal completed by a disinterested third party
PLUS ONE OF THE FOLLOWING ADDITIONAL VALUATIONS:
County valuation of property
Attached
(real property)
Informal valuation of property by disinterested third party
Attached
Attached
Proposed selling price (for property being sold at auction)
Attached
Other:
AND for applications under Section 6325(b)(1), valuation information (of the type described above in this section) must also be
provided for property remaining subject to the lien.
www.irs.gov
Catalog Number 54727S
14135
Form
(Rev. 06-2010)
Page 3 of 3
10. Copy of Federal Tax Lien(s)
(Complete if applicant and taxpayer differ)
Attached
No
OR list the lien number(s) found near the top right corner on the lien document(s)
(if known)
11. Copy of the sales contract/purchase agreement
Attached
No
(if available)
OR
Describe how and when the taxpayer will be divested of his/her interest in the property:
12. Copy of a current title report
Attached
No
OR
List encumbrances senior to the Federal Tax Lien. Include name and address of holder; description of encumbrance,
e.g., mortgage, state lien, etc.; date of agreement; original loan amount and interest rate; amount due at time of
application; and family relationship, if applicable
:
(Attach additional sheets as needed)
13. Copy of proposed closing statement
Attached
No
(aka HUD-1)
OR
Itemize all proposed costs, commissions, and expenses of any transfer or sale associated with property
(Attach
additional sheets as needed):
14. Additional information that may have a bearing on this request, such as pending
Attached
No
litigation, explanations of unusual situations, etc., is attached for consideration
15. Escrow Agreement
(For applications under IRC 6325(b)(3))
Attached
No
Escrow agreement must specify type of account, name and depositary for account,
conditions under which payment will be made, cost of escrow, name and address of any
party identified as part of escrow agreement, and signatures of all parties involved including
Advisory Group Manager. Terms for agreement must be reached before discharge approved.
16. WAIVER
(For applications made by third parties under IRC 6325(b)(2))
If you are applying as an owner of the property and you are not the taxpayer, to have this application considered under section
6325(b)(2), you must waive the rights that would be available if the application were made under section 6325(b)(4). If you choose
not to waive these rights, the application will be treated as one made under 6325(b)(4) and any payment will be treated like a
deposit under that section. Please check the appropriate box.
I understand that an application and payment made under section 6325(b)(2) does not provide the judicial remedy
available under section 7426(a)(4). In making such an application / payment, I waive the option to have the payment
treated as a deposit under section 6325(b)(4) and the right to request a return of funds and to bring an action under
section 7426(a)(4).
Waive
No
17. Declaration
Under penalties of perjury, I declare that I have examined this application, including any accompanying schedules, exhibits,
affidavits, and statements and to the best of my knowledge and belief it is true, correct and complete.
Signature/Title
Date
Signature/Title
Date
Catalog Number 54727S
www.irs.gov
14135
Form
(Rev. 06-2010)
Page of 3