ROD 22, Release of Lien — Hospital, is the District of Columbia form on which a hospital releases an injured party from a Notice of Hospital Lien that was recorded in the Recorder of Deeds Division. The form carries the Government of the District of Columbia Office of Tax and Revenue (OTR) heading, with the Recorder of Deeds address and phone number. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the original PDF is published by OTR at otr.cfo.dc.gov.
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What is ROD 22?
ROD 22, Release of Lien — Hospital, is the District of Columbia form on which a hospital states that it grants and releases an injured party from a Notice of Hospital Lien previously recorded in the Recorder of Deeds Division.
The form identifies the lien it releases: the date the notice was recorded, the Instrument Number, the injured party named in it and the amount of the lien. The hospital then certifies two things. First, that a copy of the release was sent by return receipt requested to the person(s), firm(s) or corporation(s) alleged to be liable to the injured party, stating the date of filing, and also to the insurance company that has insured that person, firm or corporation against the liability, where the name of the insurance carrier has been ascertained. Second, that the person signing is authorized to sign on behalf of the hospital.
The signer affirms under penalty of law that the statements are correct and true to the best of their information, knowledge and belief. The signature is subscribed and sworn before a notary public, so the form includes a notary signature line, a commission expiration date in mm/dd/yyyy format and a space for the notary seal.
The form is headed Government of the District of Columbia, Office of Tax and Revenue, Recorder of Deeds, 1101 4th Street, SW, Washington, DC 20024, phone (202)727-5374. It releases a lien; it does not create one.
Who needs to file ROD 22?
A hospital that recorded a Notice of Hospital Lien in the Recorder of Deeds Division and is now releasing the injured party from that lien completes ROD 22. The person who signs certifies on the form that they are authorized to sign on behalf of the hospital, so the form is completed for the hospital by its authorized representative.
The form is not completed by the injured party. The injured party is the person named in the release, not the one who signs it.
The release also involves others who do not complete it but receive a copy. The form states that a copy is sent by return receipt requested to the person(s), firm(s) or corporation(s) alleged to be liable to the injured party, and to the insurance company that has insured them against that liability where the carrier's name has been ascertained.
A notary public must also be present, because the hospital's signature is subscribed and sworn before the notary. The form is only for a lien recorded by a hospital: it identifies the lien by recording date, Instrument Number and amount, and it has no section for any other kind of lien.
When to file ROD 22
The triggering event is the hospital's decision to release a Notice of Hospital Lien that it recorded in the Recorder of Deeds Division. The form prints no due date, filing window or renewal period, so no separate deadline is attached to it.
The form does tie several dates together. It asks for the date the release is signed and sworn before the notary, the date the original lien notice was recorded, and the date on which a copy of the release was sent by return receipt requested to the party alleged to be liable and to the insurer. Have the recording date and Instrument Number of the lien on hand before you start. OTR's page for the form shows no filing date or tax year, since the release is tied to a specific recorded lien and not to a tax period.
How to fill out ROD 22
Enter the date of the release
At the top, fill in the "On this ___ day of ___" lines with the day and month on which the release is signed. Have the Notice of Hospital Lien nearby for the details that follow.
Name the hospital
Enter the name of the hospital giving notice and, on the "Located at" line, the hospital's address.
Identify the recorded lien
Enter the day, month and year the Notice of Hospital Lien was recorded in the Recorder of Deeds Division, and the Instrument Number printed on the recorded notice.
Enter the injured party's name
Write the injured party's first name, middle initial and last name in the "against" line, then repeat the same name in the release line. Match the name on the recorded lien.
Enter the lien amount
In the "in the amount of" line, write the dollar amount of the lien exactly as it appears in the recorded notice.
Complete the mailing certification
Enter the day and month on which a copy of the release was sent by return receipt requested to the person(s), firm(s) or corporation(s) alleged to be liable and, where known, to their insurance carrier.
Confirm the signer's authority
Enter the name of the hospital in the statement that the signer is authorized to sign on its behalf.
Sign the affirmation
The hospital's authorized representative signs on the Signature line, affirming under penalty of law that the statements are correct and true. Do this in the notary's presence.
Have the notary complete the block
The notary fills in the day and month of the "Subscribed and sworn" lines, signs, enters the commission expiration date as mm/dd/yyyy and applies the notary seal.
Review and download the completed PDF
Check names, dates, Instrument Number and amount against the recorded lien, then download or print the completed PDF from FillingPDF and send it through the channels described under How to submit.
How to submit ROD 22
The form names the Recorder of Deeds as its addressee and gives no other channel, no online portal and no appointment rule.
- Recorder of Deeds: the form header gives Recorder of Deeds, 1101 4th Street, SW, Washington, DC 20024, phone (202)727-5374. The lien being released was recorded in the Recorder of Deeds Division, so confirm with that office by phone how it accepts the signed and notarized release.
- Copy to the liable party and insurer: separately from the release itself, the form certifies that a copy was sent by return receipt requested to the person(s), firm(s) or corporation(s) alleged to be liable, and to the insurance company where its name has been ascertained.
Before sending, check that the hospital's authorized signer has signed and that the notary has completed the notary signature, commission expiration date and seal. The form does not mention a fee, so ask the Recorder of Deeds whether any applies. FillingPDF lets you fill out and download the PDF; submission follows the agency's channels above.
Common mistakes to avoid
- Leaving the form without a notary: the signature must be subscribed and sworn before a notary public, who signs, enters the commission expiration date and adds the seal.
- Signing before meeting the notary, when the form says the statements are sworn before the notary.
- Entering the wrong recording date, Instrument Number or lien amount, so the release does not match the Notice of Hospital Lien it is meant to release.
- Writing the injured party's name differently from the name on the recorded lien notice.
- Omitting the date on which the copy of the release was sent by return receipt requested.
- Not sending a copy to the insurance company that insures the person, firm or corporation alleged to be liable, when the carrier's name has been ascertained.
- Having someone sign who is not authorized to sign on behalf of the hospital, although the form certifies that authority.
- Entering the notary's commission expiration date in a format other than mm/dd/yyyy.
Frequently asked questions
What is ROD 22, Release of Lien — Hospital?
ROD 22 is the District of Columbia form on which a hospital releases an injured party from a Notice of Hospital Lien recorded in the Recorder of Deeds Division. It identifies the lien by recording date, Instrument Number, injured party and amount.
Who signs the ROD 22 release?
An authorized representative of the hospital signs. The form includes a certification that the signer is authorized to sign on behalf of the named hospital, and the signature is affirmed under penalty of law.
Does ROD 22 have to be notarized?
Yes. The form says the signature is subscribed and sworn before a notary public, and it provides lines for the notary's signature, the commission expiration date (mm/dd/yyyy) and the notary seal.
Who gets a copy of the hospital lien release?
The form certifies that a copy is sent by return receipt requested to the person(s), firm(s) or corporation(s) alleged to be liable to the injured party, and to the insurance company that insures them against that liability, where the carrier's name has been ascertained.
Where do I send ROD 22?
The form is headed Recorder of Deeds, 1101 4th Street, SW, Washington, DC 20024, phone (202)727-5374, and names no other channel. Because the lien was recorded in the Recorder of Deeds Division, call that office to confirm how it accepts the release.
Is there a deadline to file ROD 22?
The form prints no deadline. It is used when a hospital decides to release a lien it recorded, so the timing follows that decision. It does ask for the date the release was sent to the liable party and insurer.
Can I fill out ROD 22 online?
You can fill out the ROD 22 PDF online on FillingPDF and download or print it. FillingPDF is an independent service, not affiliated with OTR, and it does not file the release; it goes through the Recorder of Deeds channels.
What information do I need from the original lien?
You need the date the Notice of Hospital Lien was recorded, its Instrument Number, the injured party's full name and the lien amount. The form asks for each of these to identify the lien being released.
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