Georgia Application for Certificate of Release of Property from State Tax Execution

Application for Certificate of Release of Property from State Tax Execution
Application for Certificate of Release of Property from State Tax Execution
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Georgia Department of Revenue

Application for Certificate of Release of
Property from State Tax Execution
● Complete the entire application.
● Enter NA (not applicable/not available) when appropriate.
● Attachments and exhibits should be included as needed

Form

CD-14135

(August 2014)

● Additional information may be requested of you or a
third party to clarify the details of the transaction(s).
● Instructions on how to fill out this form are provided at
the end of this application.

1. Taxpayer Information (Individual or Business named on the state tax execution):
Name appearing on state tax execution

Primary Social Security Number
(last 4 digits only)

Name Continuation (if necessary)

Secondary Social Security Number
(last 4 digits only)

Address (Number Street, P.O. Box)

City

State

Employer Identification Number

ZIP Code

Telephone Number

Fax Number

2. Applicant Information
Name (First, Middle Initial, Last)

Relationship to taxpayer

Address (Number, Street, P.O. Box)
City

State

ZIP Code

Telephone Number

Fax Number

3. Attorney/Representative Information
Name (First, Middle Initial, Last)

Interested represented (e.g. taxpayer, lender, etc.)

Address (Number, Street, P.O. Box)

Power of Attorney (RD-1061) or Disclosure Authorization
Form (RD-1062) attached?

Yes

City

State

ZIP Code

Telephone Number

No

Fax Number

4. Monetary Information
► Proposed sales price:
► Expected proceeds to be paid to State of Georgia in exchange for the certificate of release:

Form CD-14135 (Rev. 3-2012)

www.dor.ga.gov

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5a. Description of Property (if real property, a copy of the deed or title showing the property’s legal description is
required)

Address of real property (if this is personal property, list the address where the property is located):
Address (Number, Street, P.O. Box)

City

6.

State

ZIP Code

Appraisal and Valuations
REQUIRED APPRAISAL
Professional appraisal completed by a disinterested third party

Attached

OR ONE OF THE FOLLOWING ADDITIONAL VALUATIONS:

7.

County valuation of property (real property)

Attached

Informal valuation of property by disinterested third party

Attached

Proposed selling price (for property being sold at auction)

Attached

Other:

Attached

Copy of state tax execution(s)

Attached

Not attached

OR list the lien number(s) found near the top right corner on the lien document(s) (if known)

8.

Copy of the sales contract or purchase agreement

Attached

Not attached

OR
Describe how and when the taxpayer will be divested of his/her interest in the property:

9.

Copy of arm’s length transaction affidavit

Attached

Not attached

OR
Describe why such an affidavit is not required:

Form CD-14135 (Rev. 3-2012)

www.dor.ga.gov

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10. Copy of a current title report

Attached

Not attached

OR
List encumbrances senior to the state tax execution. Include name and address of holder description of
encumbrance e.g., mortgage, federal tax lien, judgments, 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):

11. Copy of proposed closing statement (aka HUD-1)

Attached

Not attached

OR
Itemize all proposed costs, commissions, and expenses of any transfer or sale associated with property (attach
additional sheets as needed):

12. Additional information that may have a bearing on this request, such
pending litigation, explanations of unusual situations, etc., is attached
for consideration

Attached

Not attached

13. Declaration
I/We declare that this application, including any accompanying schedules, exhibits, affidavits, and statements is to the best of my
knowledge and belief it is true, correct and complete. Additionally, I/We understand that to willfully prepare or present a
document that is fraudulent or false is a crime under O.C.G.A. § 48-1-6.

____________________________________

___________________________
Date

____________________________________

___________________________
Date

Signature/Title

Signature/Title

Form CD-14135 (Rev. -2012) 

-3-

www.dor.ga.gov

(revised 3/2012)

Georgia Department of Revenue
Instructions on how to apply for

Certificate of Release of Property from State Tax Execution
2. If you are not the taxpayer or you are the taxpayer but
your information is no longer the same as the information
on the state tax execution, enter your name (include any
name changes), current address, daytime phone number
and fax number.

A Certificate of Release under the Georgia Public
Revenue Code (O.C.G.A. 48-2-58) removes the State of
Georgia’s tax lien (also known as tax execution) from the
property named in the certificate. This release pertains
solely to the property listed in the application and does
not release the taxpayer from any remaining tax
liabilities.
1. Complete Form CD-14135, Application for Certificate
of Release of State Tax Lien attached with this
publication.
2. Either fax the completed Form CD-14135 and the
appropriate attachments to (404) 417-6513 or mail to:

3. If you are not the taxpayer, enter in the box next to
“Name” your relationship to the taxpayer (e.g. parent,
uncle, sister, no relation, etc).

Section 3 - Attorney/Representative Information
This section is used to list the taxpayer’s representative
or a representative of a party other than the taxpayer
(e.g., the lender) needing to receive information from the
DOR. However, you do not need a representative to
request a release of the state tax execution.

Georgia Department of Revenue
Attn: Accounts Receivable Collections – Liens
1800 Century Blvd. NE
Suite 9100
Atlanta, GA 30345

1. You must provide either Form RD-1062 (Disclosure
Authorization Form) or Form RD-1061 (Power of
Attorney) with your application if the representative
represents an interest other than the taxpayer. If you are
submitting either of these forms, please make sure it is
completely filled out, signed, and dated.

If you have any questions or want to know how much you
owe in order to pay the lien(s) in full, call (404) 417-6543,
visit the nearest Department of Revenue (DOR) Regional
Office, or contact the revenue officer assigned to your
case.

2. Enter the name, address, phone number, and fax
number of your representative in this action. The DOR
will work with you and your representative to process
your application. Enter “NA” on the name line if you are
not using a representative.

Important!
Please submit your application at least 30 days before
the closing or transaction date that the certificate of
release is needed. Doing so will allow sufficient time for
review, determination, notification and the furnishing of
any applicable documents by the transaction date.

Information Required on the Application

3. Enter whose interest the representative represents
(e.g., taxpayer, lender, title company, etc.). This allows
the Department to determine what information can be
shared with the representative.

Section 1 - Taxpayer Information

Section 4 – Monetary Information

1. Enter the name and address of the individual(s) or
business as it appears on the state tax execution. A
second name line is provided if needed.

1. Provide the proposed property sale amount and the
amount of proceeds the Georgia Department of Revenue
can expect to be applied to the tax liability as
consideration for the lien release.

2. Enter, if known, the last 4 digits of the social security
number (SSN) or full employer identification number as it
appears on the state tax execution.

2. If you anticipate there will be no proceeds, the
Department will require a minimum amount for executing
the release.

3. Enter, if known and if applicable, the last 4 digits of
any spousal SSN (secondary SSN) associated with the
tax debt listed on the state tax execution.

Section 5 - Description of Property
1. Enter a detailed description of the property to be
discharged from the state tax execution.

4. Provide, if known, a daytime phone number and a fax
number.

Section 2 - Applicant Information

2. Provide the physical address if real estate or physical
location address if personal property.

1. If you are both the taxpayer and the applicant, and
your information is the same as listed on the tax
execution, enter “same as above” on the name line.

3. A certificate of release for a state tax lien from real
estate requires a legal description of the property
located on the deed.

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(revised 3/2012)

Section 6 - Appraisal and Valuations

of any transfer or sale associated with property. Attach a
separate sheet with the information if there is not enough
space provided on the form.

1. Check the “Attached” box after “Required Appraisal” to
indicate whether you have attached the required
appraisal by a disinterested third party.

Section 12 - Additional Information

2. Check the appropriate box under the “Or One of the
Following Additional Valuations” section to indicate which
other type of property value verification is attached with
your application.

1. Check the box indicating whether you are attaching
other documents relevant to the discharge application.
This could include affidavits or court documents.
2. Check the “not attached” box if you do not have any
additional documentation.

3. Short sales – An appraisal is not needed for a short
sale (i.e., a type of sale when a lender accepts a discount
on a mortgage to avoid a possible foreclosure auction or
bankruptcy). However, DOR does require an approval
letter from the mortgage holder for the approval of the
sale amount.

Section 13 - Declaration
The applicant or their authorized Power of Attorney signs
the application form. You must sign your application
under penalties of perjury attesting to having examined
the application, accompanying schedules or documents,
exhibits, affidavits, and statements and declaring to the
best of your knowledge and belief that it is true, correct
and complete.

Section 7 – State Tax Executions
1. Check the “attached” box if you have attached copies
of the state tax executions with your application.

Frequently Asked Questions

2. If you checked the “not attached” box list the state tax
execution number if available. If you do not have the
number(s), enter “unknown” in the first box.

Q1: When do I make a payment?
The Department will notify you when to send payment
after determining the amount due. Do not send a
payment with the application.

Section 8 - Sales Contract/Purchase Agreement
1. Check the box indicating whether the proposed sales
contract or purchase agreement is attached.

Q2: What is an acceptable form of payment?
Make payments by certified check, cashier’s check, or
treasurer’s check, or a closing attorney's escrow check.
If you pay by personal check, issuance of the certificate
of release will be delayed until the bank honors the
check.

2. If you checked the “not attached” box, describe how
the taxpayer named on the state tax execution will be
divested of their interest in the property or why they have
no interest in the property.

Section 9 – Arm’s Length Transaction

Q3: Who makes the decision to issue a
Certificate of Release?

1. Check the “Attached” box if an arm’s length
transaction affidavit is attached.

The Department’s Compliance Division staff will review
and verify the information provided, determine whether a
certificate of release should be issued, and contact you,
your representative, or any person relative to the
transaction for additional information.

2. If an arm’s length affidavit is not attached, please
provide an explanation why such an affidavit is not
provided.

Section 10 – Title Report
1. Check the box indicating whether the title report is
attached.

The State Revenue Commissioner has the responsibility
to review and approve the determination. If approved,
you will receive a conditional commitment letter.

2. If you checked the “not attached” box, use the space
provided to list any encumbrances (liens or claims)
against the property that came into existence before the
State of Georgia’s lien interest or which have priority over
the lien.

Q4: When will I receive the Certificate of
Release?
You will receive the certificate after the Department
receives payment of the agreed upon amount in partial
satisfaction of the tax liability, proof that the taxpayer has
been divested of title, and receipt of a copy of the final
settlement statement.

Section 11 - Closing Statement
1. Check the box indicating whether the proposed closing
statement is attached. This statement is often referred to
as a HUD-1 and is required for real estate sales.
2. If you checked the “not attached” box (e.g., sales of
tangible personal property), use the space provided to
itemize all proposed costs, commissions, and expenses

2