Form 14134
(June 2010)
Application for Certificate of Subordination of
Federal Tax Lien
Department of the Treasury — Internal Revenue Service
OMB No. 1545-2174
Complete the entire application. Enter NA (not applicable)
, when appropriate. Attachments and exhibits should be included as
necessary. Additional information may be requested to clarify the details of the transaction(s).
1. Taxpayer Information (Individual or Business named on the notice of lien)
Name (Individual First, Middle Initial, Last) or (Business) as it appears on lien
Name Continuation
(Individual First, Middle Initial, Last) or (Business d/b/a)
Address (Number, Street, P.O. Box)
Primary Social Security Number
(last 4 digits only)
Secondary Social Security Number
(last 4 digits only)
Employer Identification Number
City
State
ZIP Code
Telephone Number
(with area code)
Fax Number (with area code)
2. Applicant Information
Check if also the Taxpayer
(If not the taxpayer, attach copy of lien. See Sec.10)
Name (First, Middle Initial, Last) Relationship to taxpayer
Address
(Number, Street, P.O. Box)
City
State
ZIP Code
Telephone Number
(with area code)
Fax Number (with area code)
3. Property Owner
Check if also the Applicant
Relationship to Taxpayer
4. Attorney/Representative Information
Attached: Form 8821 or
Power of Attorney Form 2848
Yes No
Name (First, Middle Initial, Last) Interest Represented (e.g. taxpayer, lender, etc.)
Address (Number, Street, P.O. Box)
City
State
ZIP Code
Telephone Number
(with area code)
Fax Number (with area code)
5. Lending/Finance Company
Company Name
Contact Name
Contact Phone Number
Type of transaction
(For example, loan consolidation, refinance, etc)
Catalog Number 54726H
www.irs.gov
Form
14134 (Rev. 06-2010)