Form Ct-4422 Uge "Application for Certificate Releasing Connecticut Estate Tax Lien for Estates of Decedents Dying on or After January 1, 2005" - Connecticut

Form CT-4422 UGE is a Connecticut Department of Revenue Services form also known as the "Application For Certificate Releasing Connecticut Estate Tax Lien For Estates Of Decedents Dying On Or After January 1, 2005". The latest edition of the form was released in June 1, 2017 and is available for digital filing.

Download an up-to-date Form CT-4422 UGE in PDF-format down below or look it up on the Connecticut Department of Revenue Services Forms website.

ADVERTISEMENT
Department of Revenue Services
Form CT-4422 UGE
Estate Tax Section
PO Box 2972
Application for Certifi cate Releasing Connecticut Estate Tax Lien
Hartford CT 06104-2972
For estates of decedents dying on or after January 1, 2005
(Rev 06/17)
Complete this form in blue or black ink only.
Complete a seperate Form CT-4422 UGE for each property location for which a release of lien is requested.
Decedent’s name (last, fi rst, middle initial)
Date of death
Connecticut Probate Court
/
/
__ __
__ __
__ __ __ __
PD -
m m
d d
y y y y
Decedent’s residence at date of death (street address)
Social Security Number (SSN)
• •
• •
__ __ __
__ __
__ __ __ __
City, town, or post offi ce
State
ZIP code
Federal Employer ID Number (FEIN)
(If applicable)
Mailing address (fi rm name and name of attorney)
Number and street
PO Box
City, town, or post offi ce
State
ZIP code
Property address for which release is being requested (attach legal description, if necessary):
On the date of death, decedent was:
Connecticut resident
Nonresident - Attach Form C-3, State of Connecticut Domicile Declaration, and death certifi cate.
Was this property reported on the decedent’s
Is the estate required to fi le a federal Form 706,
If Form CT-706/709 EXT, Application for Estate
Connecticut Form CT-706/709, Connecticut
United States Estate (and Generation-Skipping
and Gift Tax Return Filing Extension and for
Estate and Gift Tax Return?
Transfer) Tax Return?
Estate Tax Payment Extension, was fi led, enter
the extended due date:
Yes
N o
Not yet, but will be
Yes
N o
/
/
__ __
__ __
__ __ __ __
m m
d d
y y y y
/
/
Date of Closing:
__ __
__ __
__ __ __ __
Section 1 - Estimated Connecticut Estate Taxes
m m
d d
y y y y
1. Sales price or fair market value of property on date of death
1.
00
2. Estimated Connecticut taxable estate
2.
00
3. Estimated amount of Connecticut estate and gift taxes due: See Tax Table for Form CT-706/709.
3.
00
4. Prior payments made
4.
00
5. Estimated balance to be paid: Subtract Line 4 from Line 3.
5.
00
6. Payment made with this application
6.
00
Section 2
Affi rmation: To the best of my knowledge and belief, the property for which the release of lien is being requested is or was in an estate
for which the amount of the Connecticut taxable estate exceeds the exemption amount for the year of death; and
I agree to hold suffi cient proceeds in a Connecticut escrow account to satisfy the total amount of Connecticut estate and gift taxes, interest,
and penalty, if applicable, which may be due. I agree to make payment:
By the payment due date; or
At the time of closing, if after the due date. Late payments must include interest and penalty, if applicable.
Section 3
Legal Relationship: Check the appropriate boxes to describe your status in this real estate transaction.
A. Connecticut attorney representing:
Decedent’s estate listed above
Seller in this real estate closing
Buyer in this real estate closing
B. Corporate fi duciary of:
Decedent’s estate listed above 
Seller in this real estate closing
Buyer in this real estate closing
Name of applicant
Telephone number
Fax number
(
)
(
)
Address of applicant
City, town, or post offi ce
State
ZIP code
Signature of attorney or corporate fi duciary
Date
Department of Revenue Services
Form CT-4422 UGE
Estate Tax Section
PO Box 2972
Application for Certifi cate Releasing Connecticut Estate Tax Lien
Hartford CT 06104-2972
For estates of decedents dying on or after January 1, 2005
(Rev 06/17)
Complete this form in blue or black ink only.
Complete a seperate Form CT-4422 UGE for each property location for which a release of lien is requested.
Decedent’s name (last, fi rst, middle initial)
Date of death
Connecticut Probate Court
/
/
__ __
__ __
__ __ __ __
PD -
m m
d d
y y y y
Decedent’s residence at date of death (street address)
Social Security Number (SSN)
• •
• •
__ __ __
__ __
__ __ __ __
City, town, or post offi ce
State
ZIP code
Federal Employer ID Number (FEIN)
(If applicable)
Mailing address (fi rm name and name of attorney)
Number and street
PO Box
City, town, or post offi ce
State
ZIP code
Property address for which release is being requested (attach legal description, if necessary):
On the date of death, decedent was:
Connecticut resident
Nonresident - Attach Form C-3, State of Connecticut Domicile Declaration, and death certifi cate.
Was this property reported on the decedent’s
Is the estate required to fi le a federal Form 706,
If Form CT-706/709 EXT, Application for Estate
Connecticut Form CT-706/709, Connecticut
United States Estate (and Generation-Skipping
and Gift Tax Return Filing Extension and for
Estate and Gift Tax Return?
Transfer) Tax Return?
Estate Tax Payment Extension, was fi led, enter
the extended due date:
Yes
N o
Not yet, but will be
Yes
N o
/
/
__ __
__ __
__ __ __ __
m m
d d
y y y y
/
/
Date of Closing:
__ __
__ __
__ __ __ __
Section 1 - Estimated Connecticut Estate Taxes
m m
d d
y y y y
1. Sales price or fair market value of property on date of death
1.
00
2. Estimated Connecticut taxable estate
2.
00
3. Estimated amount of Connecticut estate and gift taxes due: See Tax Table for Form CT-706/709.
3.
00
4. Prior payments made
4.
00
5. Estimated balance to be paid: Subtract Line 4 from Line 3.
5.
00
6. Payment made with this application
6.
00
Section 2
Affi rmation: To the best of my knowledge and belief, the property for which the release of lien is being requested is or was in an estate
for which the amount of the Connecticut taxable estate exceeds the exemption amount for the year of death; and
I agree to hold suffi cient proceeds in a Connecticut escrow account to satisfy the total amount of Connecticut estate and gift taxes, interest,
and penalty, if applicable, which may be due. I agree to make payment:
By the payment due date; or
At the time of closing, if after the due date. Late payments must include interest and penalty, if applicable.
Section 3
Legal Relationship: Check the appropriate boxes to describe your status in this real estate transaction.
A. Connecticut attorney representing:
Decedent’s estate listed above
Seller in this real estate closing
Buyer in this real estate closing
B. Corporate fi duciary of:
Decedent’s estate listed above 
Seller in this real estate closing
Buyer in this real estate closing
Name of applicant
Telephone number
Fax number
(
)
(
)
Address of applicant
City, town, or post offi ce
State
ZIP code
Signature of attorney or corporate fi duciary
Date
ADVERTISEMENT