Fill and Sign the Redeem Property Form

(1) Please give the name and address of the person requesting the United States to release its right to redeem property under Internal Revenue Code Section 7425(d). ___________________________________________ By: _______________________________________ (2) Describe the property for which you are requesting the United States to release its right of redemption. Use the description in the title or deed to the property, or attach a copy of the title or deed. Include street address, city, and State. Indicate whether it was a personal residence, rental property, commercial property, unimproved property, etc., at the time of the nonjudicial sale. Type Property: Residential (3) Furnish the following information about the no judicial sale (such as a foreclosure, execution, or State or local tax sale): (a) Date sale was held. (b) Name and address of the District Director to whom notice of sale was sent. (c) Name and address of purchaser. (d) Purchase price. (4) If the property owner at the date of this application was not the purchaser at the no judicial sale, give the owner's name and address. (5) List the encumbrances and charges you want to have considered. For each encumbrance show: (a) Name and address of holder. (b) Description of the encumbrance. (c) Date it arose. (d) If the encumbrance was recorded, give the date and place. (e) The original amount of the encumbrance and the interest rate. (f) The principal amount due as of the date of the application, if known, (Show costs and accrued interest separately.) (g) Your family relationship, if any, to the holder of any encumbrance on the property. (6) Attach a copy of each Notice of Federal Tax Lien (Form 668) affecting the property, or furnish the following information as it appears on each filed Notice of Federal Tax Lien: (a) Name of the Internal Revenue District. (b) Name and address of the taxpayer. (c) Date and place each notice was filed. (7) Give your estimate of the fair market value of the real property. __________ (8) Furnish any additional information that you believe would effect the application. (9) Supply any other information that the District Director or his or her delegate request. (10) Give a daytime telephone number where you may be reached. (11) Give the name, address and telephone number of your attorney or other representative if you have one. (12) You must make the following decimation over your signature and title: "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." Respectfully submitted, _____________________________