Section B Declaration by the appropriate person
To the best of my/our knowledge and belief, the information given above is correct. I am/we are not aware of any other
information which I/we should disclose. I/we apply for a statutory certificate of discharge.
Name
Signature
Capacity*
Date
Name
Signature
Capacity*
Date
Name
Signature
Capacity*
Date
Name
Signature
Capacity*
Date
Section C: Certificate (for official use)
The Commissioners of HM Revenue and Customs discharge the above named applicant(s) from any (further) claim for tax or
duty on the value attributable to the property at section A, on the occasion specified at section A except for any tax which is
being paid by instalments
Signed by
Date DD MM YYYY
for and on behalf of the Commissioners
This certificate is given under Inheritance Tax Act 1984 s239(2) or Finance Act 1975 sch.4 para.25 (2) or Finance Act 1894
s11(2) and does not itself constitute a determination of values of individual items for any other HM Revenue and Customs
purpose. In particular, the issue of the certificate does not necessarily mean that values have been ‘ascertained’ or that values
may be taken as market values for Capital Gains Tax within the provisions of section 274 and paragraph 9, schedule 11,
Taxation of Chargeable Gains Act 1992. This certificate is not valid in certain circumstances, such as in the case of fraud or
failure to disclose material facts or if further tax becomes payable as a result of an instrument of variation - see section 239 (4)
Inheritance Tax Act 1984.
Where to send the form
Send the completed form to:
Inheritance Tax
HM Revenue and Customs
BX9 1HT
For more information contact:
Probate and IHT Helpline 0300 123 1072
Outside the UK +44 300 123 1072
www.gov.uk/inheritance-tax
If you need a copy of any of our forms and leaflets you
can download them from our website.
* Capacity for example executor, administrator, transferee, trustee. Professional agents must not sign this form on behalf of
the appropriate persons.
