Form 12277 - Application For Withdrawal Of Filed Form 668(Y), Notice Of Federal Tax Lien
Download a blank fillable Form 12277 - Application For Withdrawal Of Filed Form 668(Y), Notice Of Federal Tax Lien in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 12277 - Application For Withdrawal Of Filed Form 668(Y), Notice Of Federal Tax Lien with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Department of the Treasury — Internal Revenue Service
Application for Withdrawal of Filed
12277
Form
Form 668(Y), Notice of Federal Tax Lien
(October 2011)
(Internal Revenue Code Section 6323(j))
1. Taxpayer Name
2. Social Security/Employer Identification No.
(as shown on the Notice of Federal Tax Lien)
3. Taxpayer's Representative, if applicable, or Name and Title of contact person, if taxpayer is a business
4. Address
(Number, Street, P.O. Box)
5. City
6. State
7. ZIP code
8. Phone Number
9. Attach copy of the Form 668(Y), Notice of Federal Tax Lien, if available, OR, if you don't have a copy, provide the
following information, if available:
Serial number of Form 668(Y)
Date Form 668(Y) filed
(found near the top of the document)
Recording office where Form 668(Y) was filed
10. Current status of the federal tax lien
("x" appropriate box)
Open
Released
Unknown
11. Reason for requesting withdrawal of the filed Notice of Federal Tax Lien
("x" appropriate box(es))
The Notice of Federal Tax Lien was filed prematurely or not in accordance with IRS procedures.
The taxpayer entered into an installment agreement to satisfy the liability for which the lien was imposed
and the agreement did not provide for a Notice of Federal Tax Lien to be filed.
The taxpayer is under a Direct Debit Installment Agreement.
Withdrawal will facilitate collection of the tax.
The taxpayer, or the Taxpayer Advocate acting on behalf of the taxpayer, believes withdrawal is in the
best interest of the taxpayer and the government.
12. Explain the basis for the withdrawal request
(attach additional sheets and other documentation that substantiates your
request, as needed)
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
Affirmation
Title
Date
(if business)
Signature
(Taxpayer or Representative)
12277
Catalog Number 27939C
Form
(Rev. 10-2011)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial