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Form 12277 Texas: What You Should Know

Date of Birth (Odd/Even Dates Must Be 2/3rds of even days of year). 9. Social Security Number (if under the age of 18, substitute first SSN, if over 18, SSN). If an individual does not have a valid Social Security Number, the application must be submitted as a paper copy of: (a) a Social Security card issued to the individual; or (b) a certificate of birth from a governmental entity. 10. Date of birth of dependent. 11. Proof of identification. 12. Federal Tax Exemption Number (if any). 13. Social security or government-issued ID number, including an alias. 14. Proof of Social Security, and/or government ID number, or a social security number issued to a dependent under the age of 18. 15. Date of marriage or the birth of dependent, if the individual did not file a Form 12277 earlier. 16. A completed or previously completed, and signed statement indicating that: (a) the applicant has never filed a Form 668(Y). (b) the individual is not eligible for the tax exemption; (c) the individual has no tax liability; (d) the individual has a current and valid federal or state tax exemption; (e) the individual is filing Form 668(Y) to withdraw 5000; and (f) the individual is eligible to claim the exemption. 17. A copy of the original judgment against the taxpayer in the amount of 50,000 or less, including court date and Court Name and Case Number. 18. Payment amount 50,000, plus: (a) the tax exemption; or (b) the tax liability from the judgment. 19. Court certified letter stating that the amount for the tax exemption, whether 50,000 or more, was properly deducted from the judgment. The petitioning individual may request his or her own certified copy of the letter. 20. The form contains an affidavit setting forth the reasons for the return. Form 12277 is a petition to waive or terminate a lien. If approved, the lien is waived. If rejected, the lien is terminated. This form was developed for individuals who have received a judgment for Federal tax exemption (but do not receive their income tax refund) and who are unable to resolve their case because of federal filing requirements and/or the IRS.

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