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Kentucky Free Printable Microsoft Word - Application for Specific Lien Release03-28-08.DOC for 2024 Kentucky Application for Specific Lien Release

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Application for Specific Lien Release
Microsoft Word - Application for Specific Lien Release03-28-08.DOC

12A503 03/2008 APPLICATION FOR SPECIFIC LIEN RELEASE SEND TO: 1. Department of Revenue Division of Collections Legal Support Branch P.O. Box 5222 Frankfort KY 40602 FOR QUESTIONS OR ASSISTANCE: Office: (502) 564-4921, Ext. 4436 Fax: (502) 564-7348 Name, address and telephone number of person(s) applying for the release. ____________________________________________________________________________ ____________________________________________________________________________ 2. Name and COMPLETE address of person to whom the release IS TO BE MAILED. ___________________________________________________________________________ ___________________________________________________________________________ 3. Name and address of person(s) the lien(s) filed against. ___________________________________________________________________________ ___________________________________________________________________________ 4. How will the debtor be divested of his title in the subject property? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Property is being sold for $______________________ (Attach proposed closing statement if it has been prepared.) 5. Legal description (including Book and Page Number of the Deed) and street address or location of real property; complete description and identifying numbers of personal property to be used as collateral. Attach additional sheets if necessary. If attachments are used, UNDERLINE the EXACT description of the property AS IT IS TO APPEAR ON THE RELEASE. __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ 6. Attach accurate copies of ONLY THOSE LIEN(S) which you are requesting to have released. IF SAID LIENS ARE NOT ATTACHED, THIS APPLICATION CANNOT BE PROCESSED AND WILL BE HELD WITH NO ACTION TAKEN UNTIL THE REQUIRED LIEN(S) ARE SUBMITTED. 7. List all recorded lien(s) and mortgages which are superior to Kentucky Department of Revenue lien(s). (Additional space is provided on the next page.) (1) Name & Address: (2) (3) ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ Description: ____________________ ____________________ ____________________ Date Recorded: ____________________ ____________________ ____________________ *Amount Due: ____________________ ____________________ ____________________ *Attach a written statement for each creditor holding a superior lien attesting to the balance due. (4) Name & Address: (5) (6) ____________________ ___________________ ___________________ ____________________ ___________________ ___________________ ____________________ ___________________ ___________________ Description: ____________________ ___________________ ___________________ Date Recorded: ____________________ ___________________ ___________________ *Amount Due: ____________________ ___________________ ___________________ *Attach a written statement for each creditor holding a superior lien attesting to the balance due. 8. If a tax lien has been filed by the Internal Revenue Service, a copy of that lien, as well as the specific lien release or letter of commitment given by the IRS MUST accompany this request. 9. Itemize all anticipated actual costs, commissions, and expenses of the transfer or sale of the property. (Additional space is provided on the next page.) If a lien release is to cover real estate, a copy of the closing statement should be attached and this section may be omitted. (1) Paid to: (2) (3) ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ Reason: ____________________ ____________________ ____________________ Amount: ____________________ ____________________ ____________________ (4) Paid to: (5) (6) ____________________ ___________________ ___________________ ____________________ ___________________ ___________________ ____________________ ___________________ ___________________ Reason: ____________________ ___________________ ___________________ Amount: ____________________ ___________________ ___________________ 10. Furnish information to establish the value of the property for which the specific lien release is to apply by submitting certified copies of TWO (2) professional appraisals. Include an estimate of the fair market value of the property which will remain subject to the lien. In addition: A. If public sale (auction) already held – give the date and place the sale was held, the amount for which the property was sold, and the name and address of the purchaser(s). B. If public sale (auction) to be held – give the proposed date and place of the sale, and include a statement that the Department of Revenue will be paid in its proper priority from the proceeds of the sale. 11. Please list any additional properties you own and attach copies of the property deed(s). "I DECLARE, UNDER PENALTIES OF PERJURY, THAT THIS APPLICATION HAS BEEN EXAMINED BY ME AND, TO THE BEST OF MY KNOWLEDGE AND BELIEF, IT IS TRUE, CORRECT AND COMPLETE." ______________________________________ APPLICANT Subscribed and sworn to before me this the _______ day of ________________, 200___. ______________________________________ NOTARY PUBLIC My commission expires _________________________________________________________.
Extracted from PDF file 2023-kentucky-form-12a503.pdf, last modified March 2008

More about the Kentucky Form 12A503 Other TY 2023

We last updated the Application for Specific Lien Release in February 2024, so this is the latest version of Form 12A503, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form 12A503 directly from TaxFormFinder. You can print other Kentucky tax forms here.


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Other Kentucky Other Forms:

TaxFormFinder has an additional 129 Kentucky income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Form K-4 Kentucky Withholding Certificate (K-4)
Form 10A100 Kentucky Tax Registration Application and Instructions
Form 10A104 Update or Cancellation of Kentucky Tax Account(s)
Form 62A350 Property Tax Application for Exemption Under the Homestead/Disability Amendment
Form 62F003 Instructions for Kentucky Property Tax Assessment Appeals

Download all KY tax forms View all 130 Kentucky Income Tax Forms


Form Sources:

Kentucky usually releases forms for the current tax year between January and April. We last updated Kentucky Form 12A503 from the Department of Revenue in February 2024.

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Historical Past-Year Versions of Kentucky Form 12A503

We have a total of three past-year versions of Form 12A503 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form 12A503

Microsoft Word - Application for Specific Lien Release03-28-08.DOC

2022 Form 12A503

Microsoft Word - Application for Specific Lien Release03-28-08.DOC

2021 Form 12A503

Microsoft Word - Application for Specific Lien Release03-28-08.DOC


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