Catalog Number 41642G www.irs.gov Form 4422 (Rev. 2-2018) 

Form 4422 

(February 2018) 

Department of the Treasury–Internal Revenue Service 

Application for Certificate Discharging Property 

Subject to Estate Tax Lien

OMB Number 

1545-0328

Name of decedent (last name, first name, middle initial) Decedent's Social Security Number (SSN) Date of death

Decedent's legal residence at time of death Estate's Employer

Identification Number (EIN)

As provided by Internal Revenue Code § 6325(c), I apply for a certificate discharging property subject to an estate tax lien. This 

property belongs to, or forms part of, the gross estate of the decedent named above.

If Form 706 has not been filed, provide estimate of 

tax due

$

If Form 706 has been filed, provide date Amount of tax paid with filed or unfiled 

return

$

Give the gross estate values and deductions as reported on Form 706. If Form 706 has not been filed, show approximate amounts.

Gross Estate Values

Real estate $

Stocks and bonds

Mortgages, notes, and cash

Insurance on decedent's life

Jointly owned property

Transfers during decedent's life

Powers of appointment

Annuities

Gross Estate Values (continued)

All other property

Gifts that will be reported or have 

been reported on Form 709 $

Total Gross Estate $

Deductions

Funeral and administrative 

expenses $

Debts of decedent

Marital deduction

Other deductions

Charitable gifts and bequests

Total Deductions $

If property is to be sold, transferred, or mortgaged, complete the following and see additional instructions below.

a. Election made to value certain farm and 

business real property as provided by 

IRC § 2032A

Yes 

No

b. Request granted or will be 

requested to defer payment 

of estate taxes

Yes (Complete line c.)

No

c. Payment deferred as provided by IRC § (“x” applicable 

box)

6161 6163 6166

Amount paid with Form 4768 $

Name and address of the purchaser, transferee, or mortgagee Relationship to applicant and decedent

Consideration paid or to be paid

$

Under penalties of perjury, I declare that I have examined this application, including accompanying schedules, 

exhibits, affidavits and statements, and to the best of my knowledge and belief, it is true, correct, and complete.

Applicant 

Sign here ►

Signature Date signed

Attorney for 

Applicant Sign here ►

Signature Date signed
Catalog Number 41642G www.irs.gov Form 4422 (Rev. 2-2018) 

Name and address of applicant Name and address of attorney for applicant

Relationship of applicant to estate 

(Executor, Administrator, or other title)

Phone number of applicant

( )

Phone number of attorney for applicant

( )

Physical address of the property being sold Fax number of attorney for applicant

( )

Title or Escrow Company used for settlement Contact name Phone number of contact

( )

Instructions for Completing Form 4422, 

Application for Certificate Discharging Property Subject to Estate Tax Lien 

1. If property included in the gross estate is sold, the executor must request a discharge of the specified property 

from any applicable estate tax lien. 

 Submit your application at least 45 days before the transaction date the certificate of discharge is needed. 

Doing so will allow sufficient time for review, determination, notification and the furnishing of any applicable 

documents by the transaction date. If you have any questions, contact the Advisory Estate Tax Lien Group at 

(408) 283-2062, this is not a toll free number.

2. Attach a statement giving your reasons for applying for this certificate. 

NOTE: If we have issued any other discharges on this estate, please include the dates and the amounts.

3. Attach a description of the property for which you want a certificate of discharge. Show the value of the property 

and the basis of the valuation. If the property consists of real estate, attach a separate legal description, the 

physical address of property being sold and a preliminary title report for each parcel.

4. To facilitate timely processing of the application, attach any of the following documents that apply:

• Short form of letters testamentary,

• Copy of will,

• Copy of sale contract and closing statement (or proposed closing statement),

• Copy of the current title report and appraisal,

• Copy of the Form 706

• If return is not filed a draft of Form 706, and/or a copy of the inventory and appraisement reflecting all assets 

of the estate.

• Form 4768, Application for Extension of Time to File a return and/or Pay U.S. Estate (and GenerationSkipping Transfer) Taxes

5. Submit a Form 8821, Tax Information Authorization. Completing this form gives the Internal Revenue Service the 

authority to contact individuals or companies, if necessary, when determining if the discharge is appropriate.

6. Provide the name, address, telephone and fax number of the closing attorney or representative of the settlement 

company.

7. The Internal Revenue Service may request that you furnish additional information and will have your application 

investigated to determine whether to issue the certificate. You will be informed of the outcome. 
Catalog Number 41642G www.irs.gov Form 4422 (Rev. 2-2018) 

8. If Form 706 has not yet been filed or if the Internal Revenue Service has not completed our review of Form 706, 

we will determine on a case by case basis the amount of funds, if any, the estate will be required to either pre-pay 

from the sale proceeds or have held in escrow.

9. Submit the completed Form 4422 and all supporting documents to: 

 

 Internal Revenue Service 

Advisory Estate Tax Lien Group 

55 South Market St. 

Mail Stop 5350 

San Jose, CA 95113-2324 

Attn: Group Manager 

 E-fax number: 877-477-9243

10. Requests for discharge of property described on lien Forms 668-H or 668-J will also be processed by the 

Advisory Estate Tax Lien Group, requests may be sent to the above address.

Paperwork Reduction Act

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB 

control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the 

administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by section 6103. 

The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time is: Preparing and sending 

the form to the IRS should involve 30 minutes. The estimated burden for individual taxpayers filing this form is approved under OMB control number 

1545-0328 . If you have comments concerning the accuracy of the time estimate or suggestions for making this form simpler, we would be happy to hear 

from you. You can send your comments to Internal Revenue Service, Tax Forms and Publications Division, 1111 Constitution Ave. NW, IR-6526, 

Washington, DC 20224. Do not send Form 4422 to this address.