Department of the Treasury — Internal Revenue Service 
Form 14134                                                                                                             OMB No. 1545-2174
(June 2010)           Application for Certificate of Subordination of
                                                 Federal Tax Lien 
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                 Primary Social Security Number 
                                                                                                  (last 4 digits only) 
Name Continuation (Individual First, Middle Initial, Last) or (Business d/b/a)                    Secondary Social Security Number 
                                                                                                  (last 4 digits only) 
Address (Number, Street, P.O. Box)                                                                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 

                                                 Attached:    Form 8821 or                   Yes  No
4. Attorney/Representative Information           Power of Attorney Form 2848 
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) 

                                                                                                                  Page 2 of 3 
6. Monetary Information 

Amount of existing loan (if refinancing) 

Amount of new loan 

Amount to be paid to the United States (6325(d)(1) applications only) 

7. Basis for Subordination: Check the box below that best addresses what you would like the United States to consider 
in your application for subordination. (Publication 784 has additional descriptions of the Internal Revenue Code sections listed 
below.) 

6325(d)(1)            the United States will receive an amount equal to the lien or interest to which the certificate of 
                      subordination is issued (provide amount in Section 6 above) 
6325(d)(2)            the issuance of the certificate of subordination will increase the government's interest and make 
                      collection of the tax liability easier. (Complete and attach a signed and dated statement describing how 
                      the amount the United States may ultimately realize will increase and how collection will be facilitated by 
                      the subordination.) 

                      Statement    Attached  NA 

8. Description of property (For example, 3 bedroom rental house;  2002 Cessna twin engine airplane, serial number 
AT919000000000X00; etc.): 

Address of real property (If this is personal property list the address where the property is located): 
Address (Number, Street, P.O. Box) 

City                                         State                                ZIP Code 

Real Estate: 
Legible copy of deed or title showing legal description                           Attached NA 

9. Appraisal and Valuations 
Appraisal: (Professional appraisal completed by a disinterested                   Attached 
           third party but it is not required for a subordination) 

OR ONE OF THE FOLLOWING VALUATIONS: 
County valuation of property (real property)                                      Attached 
Informal valuation of property by disinterested third party                       Attached 
Proposed selling price (for property being sold at auction)                       Attached 
Other:                                                                            Attached 

Catalog Number 54726H                                         www.irs.gov                  Form 14134 (Rev. 06-2010) 

                                                                                                           Page 3 of 3 
10. Copy of Federal Tax Lien(s) (Complete if applicant and taxpayer differ) 
                                                                                   Attached             No 
OR list the lien number(s) found near the top right corner on the lien document(s) (if known) 

11. Copy of the proposed loan agreement (if available)                             Attached             No 
AND 
Describe how subordination is in the best interests of the United States: 

12. Copy of a current title report (required for subordination)                    Attached             No 
OR 
List encumbrances with seniority over the Federal Tax Lien.  Include name and address of the holder; description of 
the encumbrance, e.g., mortgage, state lien, etc.; date of agreement; original loan amount and interest rate; amount 
due at time of application; and family relationship, if applicable. Include any home equity line of credit (HELOCs) 
advances beginning the 46th day after the NFTL was filed, through the date you submit your application, and include 
expected advances through the date the certificate will be issued. (Attach additional sheets as needed): 

13. Copy of proposed closing statement (aka HUD-1)                                 Attached             No 
OR 
Itemize all proposed costs, commissions, and expenses of any transfer or sale associated with property (Attach 
additional sheets as needed): 

14. Additional information that may have a bearing on this request, 
                                                                                   Yes Yes Yes No No No 
such as pending litigation, explanations of unusual situations, etc., 
is attached for consideration 
15. Declaration 
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. 

                                   Signature/Title                                             Date 

                                   Signature/Title                                             Date 

Catalog Number 54726H                              www.irs.gov                                 Form 14134 (Rev. 06-2010)