Was this property reported on the decedent’s Connecticut
Form CT-706/709, Connecticut Estate and Gift Tax Return?
Yes
No
Not yet, but will be
Decedent’s First Name and Middle Initial
Last Name
Date of Death
Social Security Number (SSN)
__ __ __ __ __ __ __ __ __
Decedent’s Residence at Date of Death (Street Address)
Federal Employer ID Number (FEIN) (If applicable)
City, Town, or Post Office
State
ZIP Code
Connecticut Probate Court
Mailing Address (Firm Name and Name of Attorney)
Number and Street
PO Box
City, Town, or Post Office
State
ZIP Code
Property Address (For which release is being requested; if necessary, attach legal description.)
Form CT-4422 UGE
Application for Certificate Releasing
Connecticut Estate Tax Lien
For estates of decedents dying on or after January 1, 2005
Complete this form in blue or black ink only. Complete a separate Form CT-4422 UGE and Form CT-792 UGE, Certificate Releasing
Connecticut Estate Tax Lien, for each property address requiring a release of lien.
Department of Revenue Services
Estate Tax Section
PO Box 2972
Hartford CT 06104-2972
(Rev. 9/08)
••••
Estimated Connecticut Estate Taxes
1. Sales price or fair market value of property on date of death
1.
00
2. Estimated Connecticut taxable estate
2.
00
3. Estimated amount of Connecticut estate and gift taxes due:
See Tax Table for Form CT-706/709.
3.
00
4. Prior payments made
4.
00
5. Estimated balance to be paid: Subtract Line 4 from Line 3.
5.
00
6. Payment made with this application
6.
00
Section 2
Affirmation: To the best of my knowledge and belief, the property for which the release of lien is being requested is or was in a Connecticut
taxable estate greater than $2 million; and
I agree to hold sufficient proceeds in a Connecticut escrow account to satisfy the total amount of Connecticut estate and gift taxes, interest, and
penalty (if applicable) which may be due. I agree to make payment:
By the payment due date; or At the time of closing, i