1. Federal Adjusted Gross Income (federal Form 1040, Line 11). . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 1. ___________________________ .00 2. Net Modifications to Federal AGI (Schedule IN-112, Part I, Line 17). . . . . . . . . . . . . . .. . . . . . . . . . . . . 2. ___________________________ .00 3. Federal AGI with Modifications (ADD Lines 1 and 2). . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 3. ___________________________ .00 4. 2021 Vermont Standard Deduction from filing status section above. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 4. ___________________________ .00

Please see instructions if you or your spouse checked any standard

deduction boxes on federal Form 1040, page 1. 5. Personal Exemptions:

5a. Enter “1” for yourself if no one can claim you as a dependent . . . . . . . . . . . . . . . . . . . . . . . . . . 5a. ________

5b. Enter “1” for your jointly filed spouse or CU partner if no one can claim them as a dependent or if you are a qualifying widow(er). . . . . . . . . . . . . . . . . . . . . . . . . 5b. ________

5c. Enter number of other dependents claimed on federal Form 1040. This includes any dependents other than yourself and/or your spouse. . . . . . . . . . . . . . . . . . . . . . 5c. ________

5d. ADD Lines 5a through 5c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . 5d. _ ________ 5e. MULTIPLY Line 5d by $4,350 (2021 Personal Exemption). . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . 5e. ___________________________ .00 6. ADD Lines 4 and 5e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 6. ___________________________ .00 7. Vermont Taxable Income (SUBTRACT Line 6 from Line 3. If less than zero, enter -0-). . . . . . . . . . . 7. ___________________________ .00 8. Vermont Income Tax from tax table or tax rate schedule . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 8. ___________________________ .00 (If Line 1 is greater than $150,000, see instructions) 9. Net Adjustment to Vermont Tax (Schedule IN-119, Part I, Line 16). . . . . . . . . . . . . . . . .. . . . . . . . . . . . . 9. ___________________________ .00 10. Vermont Income Tax with Adjustment (ADD Lines 8 and 9. If less than zero, enter -0-). . . . . . . . . . 10. ___________________________ .00

13. ___________________________ .00 14. Vermont Income Tax (Line 10 MINUS Line 13. If less than zero, enter -0-) . . . . . . . . . . . . . . . . . . . 14. ___________________________ .00 15. Income Adjustment (Schedule IN-113, Line 36, or 100. 0000%). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . 15. ________ . _________% 16. Adjusted Vermont Income Tax (MULTIPLY Line 14 by Line 15). . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. _ _____________________________.00 Please PRINT in BLUE or BLACK INK DEPT USE ONLY FILE YOUR RETURN ELECTRONICALLY FOR A FASTER REFUND. GO TO TAX.VERMONT.GOV FOR MORE INFORMATION. 13. Charitable Contribution Deduction (Enter the lesser of Line 12 or $1,000) . . . . . . Form IN-111 Page 1 of 2 Rev. 10/21 Vermont Department of Taxes 2021 Form IN-111 Vermont Income Tax Return Amount Due (from Line 31) .00 ___________ .00 ___________ .00 11. Tax-Deductible Charitable Contribution 12. Multiply Line 11 by 5% (0. 05)

(See instructions)

Taxpayer’s Last Name First Name MI Social Security Number

Spouse’s/CU Partner’s Last Name First Name MI Social Security Number

Mailing Address (Number and Street/Road or PO Box) 911/Physical Street Address on 12/31/2021

City State ZIP Code or Foreign Postal Code Foreign Country Vermont School District Code

Check if Deceased Check if Deceased AMENDED Return RECOMPUTED Return Qualifying Widow(er) ($12,700) Head of Household ($9,500) Married/CU Filing Separately ($6,350) Married/CU Filing Jointly ($12,700) Single ($6,350) Filing Status and Standard Deduction Enter Healthcare Coverage Code (See instructions for code options)

EXTENDED Return Check all that apply *211111100* * 2 1 1 1 1 1 1 0 0 * 5454

Keep a copy for your records. Form IN-111 Page 2 of 2 Rev. 10/21 Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct and complete. Preparers cannot use return information for purposes other than preparing returns. Other State Credit (Schedule IN-117, Line 21) Vermont Tax Credits (Schedule IN-119, Part II) Total Vermont Credits (Add Lines 17 and 18) OR Check to certify no Use Tax is due. Check if the Department of Taxes may discuss this return with the preparer shown. For Amended Returns Only:

Original refund received Refund due now Original payment Amount due now .00 .00 .00 .00 Signature Date (MM/DD/YYYY) Date of Birth (MM/DD/YYYY) Daytime Telephone Number Signature (If a joint return, BOTH must sign. ) Date (MM/DD/YYYY) Date of Birth (MM/DD/YYYY) Daytime Telephone Number Paid Preparer’s Signature

Date Preparer’s Telephone Number Firm’s Name (or yours if self-employed) and address

Preparer’s SSN or PTIN FEIN / / / / Green Up Vermont Total Contributions Vermont Veterans Fund Children’s Trust Fund Nongame Wildlife Fund / / *211111200* * 2 1 1 1 1 1 2 0 0 * Amount from Line 16 .00

Taxpayer’s Last Name Social Security Number 17. _____________________.00 + 18._____________________ .00 = 19. ___________________________ .00 20. Vermont Income Tax after credits (SUBTRACT Line 19 from Line 16. If Line 19 is greater than Line 16, enter -0-). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. ___________________________ .00 21. Use Tax for taxable items on which no sales tax was charged, including online purchases. (See instructions, worksheet, and chart). . . . 21. ___________________________ .00 22. Total Vermont Taxes (ADD Lines 20 and 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. ___________________________ .00 23a. _________.00 + 23b. _________.00 + 23c. _________.00 + 23d. _________.00 = 23e.____________ .00 24. Total of Vermont Taxes and Voluntary Contributions (ADD Lines 22 and 23e). . . . . . . . . . . . . . . . . . 24. ___________________________ .00 25a. 2021 Vermont Tax Withheld from W-2, 1099. . . . . . . . . . . . . . . . . . . . 25a. ___________________ .00 25b. 2021 Estimated Tax payments, amount carried forward from 2020, and/or payment made with 2021 extension. . . . . . . . . . . . . . . . . . . . . . . 25b. ___________________ .00 25c. Refundable Credits (Schedule IN-112, Part II, Line 11) . . . . . . . . . . . . 25c. ___________________ .00 25d. 2021 Vermont Real Estate Withholding from Form RW-171. . . . . . . . 25d. ___________________ .00 25e. 2021 Nonresident Estimated Tax payments (nonresident withholding) allocated on Schedule K-1VT, Line 5. . . . . 25e. ___________________ .00 25f. Total Payments and Credits (ADD Lines 25a through 25e). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25f. ___________________________ .00 26. Overpayment. If Line 24 is less than Line 25f, SUBTRACT Line 24 from Line 25f. . . . . . . . . . . . 26. ___________________________ .00 27a. Refund to be credited to 2022 Estimated Tax Payment. . . . . . . . . . . . . 27a. ___________________ .00 27b. Refund to be credited to 2022 Property Tax Bill. . . . . . . . . . . . . . . . . . 27b. ___________________ .00 28. REFUND AMOUNT (SUBTRACT Lines 27a and 27b from Line 26). . . . . . . . . . . . . . . . . . . . . . . 28. ___________________________ .00 29. If Line 24 is more than Line 25f, subtract Line 25f from Line 24. See instructions on tax due. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. ___________________________ .00 30. Interest and Penalty on

31. AMOUNT DUE

Underpayment of Estimated Tax. . . 30. _________________.00 (ADD Lines 29 and 30).31. ___________________________ .00 (Worksheet IN-152 or IN-152A) 5454 Clear ALL fields Save and go to Important Printing Instructions Save and Print

PART I ADDITIONS TO FEDERAL ADJUSTED GROSS INCOME 1. Total interest and dividend income from all state and local obligations exempt from federal tax (reported on federal Form 1040). . . . . . . . . . . . . . . . . . . . . . . . . . . 1. __________________________.00 2. Interest and dividend income from Vermont state and local obligations included in Line 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. __________________________.00 3. Income from Non-Vermont State and Local Obligations (SUBTRACT Line 2 from Line 1). . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. _ _________________________ .00 4. Bonus Depreciation Allowed under Federal Law for 2021. . . . . . 4. __________________________.00 5. Other (reserved) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. __________________________.00 6. Total Additions (ADD Line 3 and Line 4). . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. _ _________________________ .00 SUBTRACTIONS FROM FEDERAL ADJUSTED GROSS INCOME 7. Interest Income from U. S. Obligations. . . . . . . . . . . . . . . . . . . . . . 7. __________________________.00 8. Capital Gains Exclusion (Schedule IN-153, Line 21) . . . . . . . . . . 8. __________________________.00 9. Adjustment for Prior Years’ Bonus Depreciation. . . . . . . . . . . . . . 9. __________________________.00 10. Taxable Refunds of State and Local Income Taxes (Reported on federal Form 1040). . . . . . . . . . . . . . . . . . . . . . . . . 10. __________________________.00 11. Medical Expense Deduction (see the worksheet in the instructions). . . . . . . . . . . . . . . . . . . . . 11. __________________________.00 12. Social Security Benefits Exempt from Taxation (see the worksheet in the instructions). . . . . . . . . . . . . . . . . . . . . 12. __________________________.00 13. Railroad Retirement income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. __________________________.00 14. Bond/note interest income from (see below). . . . . . . . . . . . . . . . 14. __________________________.00 15. Other (reserved) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. __________________________.00 16. Total Subtractions (ADD Lines 7 through 14). . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. _ _________________________ .00 NET MODIFICATIONS TO FEDERAL ADJUSTED GROSS INCOME 17. SUBTRACT Line 16 from Line 6. Enter on Form IN-111, Line 2. . . . . . . . . . . . . . . . .. . . . . . . . . . . . 17. _ _________________________ .00 This can be a negative number. Please PRINT in BLUE or BLACK INK Schedule IN-112 Page 1 of 2 Rev. 10/21 INCLUDE WITH FORM IN-111 Vermont Department of Taxes 2021 Schedule IN-112 Vermont Tax Adjustments and Credits

Taxpayer’s Last Name First Name MI Taxpayer’s Social Security Number VSAC Vermont Public Power Supply Authority Vermont Telecom Authority Build America *211121100* * 2 1 1 1 2 1 1 0 0 * RESERVED RESERVED 5454

PART II REFUNDABLE CREDITS Line 1 is for FULL-YEAR residents 1. Low Income Child & Dependent Care Credit . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. _________________.00

If your federal Adjusted Gross Income is $30,000 (or $40,000 for Married Filing Jointly) or less, and child care services are provided by a Vermont accredited daycare provider, enter 50% of federal Form 2441, Line 10. If you are not a Vermont resident or your daycare provider is not accredited, use Schedule IN-119, Part I, Line 8. See instructions if your providers are both accredited and not accredited. VERMONT EARNED INCOME TAX CREDIT For FULL-YEAR residents and PART-YEAR residents ELIGIBILITY QUESTIONS MUST BE ANSWERED A. Enter number of qualifying children. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. _______________ B. Enter number of qualifying children under the age of 18. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. _______________ C. Were you (or your spouse if filing a joint return) at least age 18 at the end of 2021?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. If you answered “No” and do not have any qualifying children, you do not qualify for Earned Income Tax Credit FULL-YEAR RESIDENTS Answer eligibility questions above and complete Lines 2 and 3 2. Earned income tax credit (Reported on federal Form 1040). . . . . . . . . . . . . . . . . . . . . 2. __________________.00 3. Vermont Earned Income Tax Credit. MULTIPLY Line 2 by 36% (0.36). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. _______________ .00 PART YEAR RESIDENTS Answer eligibility questions above and complete Lines 4 through 10 4. Wages, salaries, tips, etc. (Schedule IN-113, Line 1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4A. _ ______________ .00 4B. _______________ .00 5. Other earned income (Schedule IN-113, Lines 8, 10, and 11) . . . . . . . .. . . . . . . . . . . 5A. _ ______________ .00 5B. _______________ .00 6. Total earned income (Add Lines 4 and 5). . . . . . . . . . . . . . . . . 6A. _ ______________ .00 6B. _______________ .00 7. Earned income tax credit adjustment (DIVIDE Line 6B by Line 6A, MULTIPLY the result by 100, and enter here. Do not enter more than 100%. ). . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. __________ ._______% 8. Earned income tax credit (Reported on federal Form 1040). . . . . . . . . . . . . . . . . . . . . . . . . 8. _ ______________ .00 9. Multiply Line 8 by 36% and enter the result here. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. _______________ .00 10. Vermont Earned Income Tax Credit (MULTIPLY Line 9 by Line 7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. _______________ .00 11. TOTAL REFUNDABLE CREDITS (ADD Line 1 to Line 3 or Line 10. Enter this amount on Form IN-111, Line 25c) . . . . . . . . . . . . . . . . . . . . . . . . . . 11. _______________ .00 Schedule IN-112 Page 2 of 2 Rev. 10/21 B. Vermont Portion $ For Vermont Portion, enter income earned while a Vermont resident as shown on Schedule IN-113, Column B, Lines 1, 8, 10, and 11 A. Federal Amount $ Enter figures in Column A from your federal EITC worksheet and Schedule IN-113 Yes No *211121200* * 2 1 1 1 2 1 2 0 0 *

Taxpayer’s Last Name Social Security Number 5454 Clear ALL fields Save and go to Important Printing Instructions Save and Print

2021 Schedule IN-112 Instructions tax.vermont.gov Page 1 of 3 SCHEDULE IN-112 Vermont Tax Adjustments and Credits Print your name and Social Security Number on this schedule. Please use blue or black ink to make all entries. Who Must File Schedule IN-112

You must file Schedule IN-112 if you: • Have interest income from state and local obligations (Part I) - Federal bonus depreciation - Adjustment to bonus depreciation - Interest Income from U.S. obligations - Capital Gains Exclusion - Taxable refunds of state and local income tax • Are claiming Vermont Refundable Credits (Part II) - Low Income Child & Dependent Care - Vermont Earned Income Tax Credit Part I Additions to Federal Adjusted Gross Income

Interest and dividend income from non-Vermont state and local obligations which are exempted from federal taxable income are taxable in Vermont. A Vermont obligation is one from the state of Vermont or a Vermont municipality. Line 1 Enter the total interest and dividend income received from all state and local obligations exempted from federal tax as reported on federal Form 1040, U.S. Individual Income Tax Return. Line 2 Enter the interest and dividend income from Vermont obligations. This may have been paid directly to you or through a mutual fund or other legal entity that invests in Vermont state and local obligations. If you receive this income from a mutual fund that has only a portion of its assets invested in Vermont state and local obligations, enter only the amount for the Vermont obligation(s). Line 3 Subtract Line 2 from Line 1. This is the amount of interest and dividend income from non-Vermont state and local obligations that must be included in Vermont Taxable Income. Line 4 Federal Bonus Depreciation. Vermont does not recognize the bonus depreciation allowed under federal law. Enter the difference between the depreciation calculated by standard MACRS methods and the depreciation calculated using the federal bonus depreciation for assets placed in service in 2021. Read Technical Bulletin TB-44, Disallowance of Bonus Depreciation Provisions of Federal Economic Stimulus Act of 2008, on our website for information on calculating the amount to add back to taxable income. Line 5 Reserved Line 6 Total Federal Adjusted Gross Income Additions. Add Lines 3 and 4. Subtractions From Federal Adjusted Gross Income Line 7 Interest Income from U.S. Obligations. Interest income from U.S. government obligations (such as U.S. Treasury bonds, bills, and notes) is exempt from Vermont tax under the laws of the United States. Enter the amount of interest income from U.S. Obligations on this line. Read Technical Bulletin TB-24, Exemption of Income of U.S. Government Obligations, on our website. Line 8 Capital Gains Exclusion. See Schedule IN-153, Capital Gains Exclusion Calculation, and instructions to calculate the capital gains exclusion for 2021. Read Department regulation § 1.5811(21)(B)(ii) and Technical Bulletin TB-60, Taxation of Gain on the Sale of Capital Assets, on our website to help determine your capital gain exclusion. Complete and submit Schedule IN-153. Line 9 Adjustment for Bonus Depreciation on Prior Year Property. Enter the difference between the depreciation calculated by standard MACRS methods and the depreciation calculated at the federal level. For information on calculating the amount that can be subtracted from taxable income, read Technical Bulletin TB-44 on our website. Line 10 Taxable Refunds of State and Local Income Taxes. Enter the amount reported on your federal Form 1040. Line 11 Medical Expenses Deduction. Complete the worksheet located in the instructions. Line 12 Social Security Benefits Exempt from Vermont Taxation. Complete the worksheet located in the instructions. Line 13 Enter the amount you received in 2021 for Regular Railroad Retirement Benefits (Tier 1) and Supplemental Railroad Annuity Payments (Tier 2). This income is taxable at the federal level, but exempt from Vermont income tax. If you receive Social Security that includes Tier 1 or Tier 2 benefits, enter only the portion included in your federal Adjusted Gross Income. You may be asked to provide the Required Supporting Documents: Copies of 1099, 1099RB, WP-4, or any other document you received showing payment of these benefits. Line 14 The interest or income from a bond or note of: 1) Vermont Student Assistance Corporation, 2) Build America, 3) Vermont Telecommunications Authority, or 4) Vermont Public Power Supply Authority is exempt from Vermont

2021 Schedule IN-112 Instructions tax.vermont.gov Page 2 of 3 SOCIAL SECURITY EXEMPTION WORKSHEET PLEASE READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING THIS WORKSHEET. Instructions: It is important that you answer the questions in Section I to determine if you qualify for a full or partial exemption. If you qualify for a partial exemption, you may move on to Section II to calculate the amount of the exemption. SECTION I: Do you qualify for the Vermont Social Security full or partial exemption? 1. Did you report an amount on federal Form 1040, U.S. Individual Income Tax Return, Line 6b, earning Social Security benefits that were taxable in the current tax year? c No, STOP. You do not qualify for this exemption. c Yes. Proceed to question 2. 2. If you are: • Married filing jointly, is your Adjusted Gross Income (AGI) on Form IN-111, Vermont Income Tax Return, Line 1, less than $70,000? • Single, head of household, qualifying widow(er), or married filing separately, is your AGI on Form IN-111, Line 1, less than $55,000? c No, STOP. You do not qualify for this exemption. c Yes. You qualify for Vermont’s Social Security exemption. Proceed to question 3. 3. If you are: • Married filing jointly, is your AGI less than $60,000? • Single, head of household, qualifying widow(er), or married filing separately, is your AGI less than $45,000? c No. Please proceed to Section II of this worksheet. c Yes. You qualify for a full exemption. Please enter the full amount from federal Form 1040, Line 6b, on Schedule IN-112, Part I, Line 12. SECTION II: Calculating your Social Security Partial Exemption This section is for married joint filers with an Adjusted Gross Income (AGI) between $60,000-$70,000 and for single, head of household, qualifying widow(er), or married separate filers with an AGI between $45,000- $55,000. 4. If you are:

• Married filing jointly, enter $70,000.

• All other filing statuses, enter $55,000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4. ________________ 5. Enter your AGI from Form IN-111, Line 1.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. ________________ 6. Subtract Line 5 from Line 4. If Line 5 is greater than Line 4, enter -0-.. . . . . . . . . . . . . . . . . . 6. ________________ 7. Divide Line 6 by $10,000. This value will be a decimal. Please round to the second decimal place (Example: .481 would round to .48).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. ________________ 8. Enter the lesser of Line 7 or the value 1 (This line should not be greater than 1).. . . . . . . . . . . 8. ________________ 9. Enter the amount from federal Form 1040, Line 6b.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. ________________ 10. Amount of partial exemption. Multiply Line 9 by Line 8. Enter this amount on Schedule IN-112, Part I, Line 12.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. ________________ Note about civil unions: If you are in a civil union and filing jointly, you should file for this exemption as married filing jointly. If you are a civil union and filing separately, you should file as married filing separately. MEDICAL DEDUCTION WORKSHEET 1a. Medical and Dental Expense from federal Form 1040, Schedule A, Line 4. . . . . . . . . . . . . . . 1a. ________________ 1b. Non-allowable expenses included in Line 1a (See instructions below*) . . . . . . . . . . . . . . . . . 1b. ________________ 1c. Total. Line 1a minus Line 1b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1c. ________________ 2. Amount from Vermont Form IN-111, Line 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. ________________ 3. Subtract Line 2 from Line 1c. Enter here and on Schedule IN-112, Part I, Line 11. . . . . . . . . 3. ________________ If amount on Line 3 is negative, STOP. You do not qualify for this deduction. *If you pay recurring monthly payments or entrance fees to a retirement community, these amounts are not deductible. Please enter the fees on Line 1b. Please see our website at tax.vermont.gov for more information.

2021 Schedule IN-112 Instructions tax.vermont.gov Page 3 of 3 income tax to the extent the interest or income is included in federal Adjusted Gross Income. Enter the amount of interest or income from these sources that is also included in your federal Adjusted Gross Income. Line 15 Reserved Line 16 Total Federal Adjusted Gross Income Subtractions. Add Lines 7 through 14. Line 17 Net Modifications to Federal Adjusted Gross Income. Subtract Line 16 from Line 6. If Line 6 is less than Line 16, use a hyphen (“-”) to indicate a negative. Enter on Form IN-111, Vermont Income Tax Return, Line 2. Part II Refundable Credits Line 1 Low Income Child & Dependent Care Credit (Vermont Residents only)

If care expenses are from both accredited and non- accredited providers, complete the worksheet to calculate the credit.

Eligible taxpayers receive 50% of the federal Child and Dependent Care Credit as a refundable Vermont income tax credit instead of the nonrefundable 24% credit from Schedule IN-119, Vermont Tax Adjustments and Nonrefundable Credits.

Taxpayers must meet the following requirements: • Your income must be either: - less than $30,000 federal Adjusted Gross Income for taxpayers filing as Single, Head of Household, Married Filing Separately, Civil Union Filing Separately

OR - less than $40,000 federal Adjusted Gross Income for taxpayers filing as Married Filing Jointly, Civil Union Filing Jointly, Qualifying Widow(er) • Care in 2021 must be provided by a home or facility located in Vermont accredited by the Vermont Agency of Human Services. Include a copy of your federal Form 2441, Child and Dependent Care Expenses. To determine if your care provider is accredited, go to our website or call the Department of Children and Families at (800) 649-2642. Vermont Earned Income Tax Credit (for Full-Year and Part-Year Vermont Residents Only)

In order to qualify for the Vermont Earned Income Tax Credit, a taxpayer must first be eligible for a federal Earned Income Tax Credit.

Supporting Documents Required: Evidence of earned income such as W-2 or self-employment schedule(s).

Eligibility questions A, B, and C must be answered. The claim will be disallowed if the questions are not answered. Full-Year Residents Line 2 Enter the amount of your federal Earned Income Tax Credit. Line 3 Multiply Line 2 by 36% (0.36). Enter the result. Part-Year Residents Line 4A Enter the federal amount of wages, salaries, tips, etc. Line 4B Enter the portion of federal wages, salaries, tips, etc. earned while a Vermont resident. Lines 5A & 5B Other earned income includes income from a business, partnership, or farm. Line 6A In Column A, add Lines 4 and 5 and enter the result. Line 6B In Column B, add Lines 4 and 5 and enter the result. Line 7 Divide Line 6A by Line 6B. Enter the result as a percentage carried out to two decimal places but not greater than 100%. This is the percentage of 2021 income earned in Vermont that is eligible for the Vermont Earned Income Tax Credit. Line 8 Enter the amount of your federal Earned Income Tax Credit. Line 9 Multiply Line 8 by 36% (0.36) and enter result. Line 10 Multiply Line 9 by Line 7. Enter the result. Line 11 TOTAL REFUNDABLE CREDITS

Add Line 1 to Line 3 or Line 10. Enter this amount on Form IN-111, Line 25c. 1. Accredited care provider amount. . . . . . 1.________________________

2. Total care amount. . . . . . . . . . . . . . . . . . 2.________________________

3. Divide Line 1 by Line 2. . . . . . . . . . . . . . 3.________________________ $___________ x __________ = $___________ x 50% = $ ____________ Federal Credit Line 3 above Eligible Credit Low Income Credit (Form 2441,

IN-112, Part II,

Line 10)

Line 1 You may wish to also calculate your VT tax credit using 24% of the full Federal credit and compare to the credit calculated on this worksheet to determine which credit is best for you. NOTE: You cannot take both credits. LOW INCOME CHILD & DEPENDENT CARE WORKSHEET

INCLUDE WITH FORM IN-111 Please PRINT in BLUE or BLACK INK Schedule IN-119 Page 1 of 2 Rev. 10/21 Vermont Department of Taxes 2021 Schedule IN-119 Vermont Tax Adjustments and Nonrefundable Credits *211191100* * 2 1 1 1 9 1 1 0 0 *

Taxpayer’s Last Name First Name MI Taxpayer’s Social Security Number 5454 PART I ADJUSTMENTS TO VERMONT INCOME TAX ADDITIONS TO VERMONT TAX 1. Tax on Qualified Plans including IRA, HSA, and MSA (reported on federal Form 1040, U.S. Individual Income Tax Return). . . . . 1. _____________________________ .00 2. Recapture of Federal Investment Tax Credit (reported on Form 1040). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. _____________________________ .00 3. Tax from federal Form 4972, Tax on Lump-Sum Distributions . . 3. _____________________________ .00 4. ADD Lines 1 through 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. _____________________________ .00 5. MULTIPLY Line 4 by 24% (0.24) . . . . . . . . . . . . . . . . . . . . . . . 5. _____________________________ .00 6. Recapture of Vermont Credits (See instructions). . . . . . . . . . . . . . 6. _____________________________ .00 7. ADD Lines 5 and 6.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. _ ___________________________.00 SUBTRACTIONS FROM VERMONT TAX 8. Credit for Child & Dependent Care Expenses (reported on Form 1040). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. _____________________________ .00 9. Credit for the Elderly or the Disabled (federal Schedule R). . . . . . 9. _____________________________ .00 10. Investment Tax Credit - Vermont-based only (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. _____________________________ .00 11. Vermont Farm Income Averaging Credit (from worksheet in instructions). . . . . . . . . . . . . . . . . . . . . . . . . . 11. _____________________________ .00 12. ADD Lines 8 through 11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. _____________________________ .00 13. MULTIPLY Line 12 by 24% (0.24) . . . . . . . . . . . . . . . . . . . . . 13. _____________________________ .00 14. Vermont-based Solar Energy Credit carryforward. . . . . . . . . . . . 14. _____________________________ .00 15. ADD Lines 13 and 14. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. _ ___________________________.00 NET ADJUSTMENTS TO VERMONT TAX 16. SUBTRACT Line 15 from Line 7. Enter on Form IN-111, Vermont Income Tax Return, Line 9. This can be a negative number.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. _ ___________________________.00

PART II VERMONT INCOME TAX CREDITS 1. Vermont Higher Education Investment (32 V.S.A § 5825a) See instructions. . . . . . . . . . . . . . . . . . . . ________________.00

________________.00 INCLUDE WITH FORM IN-111 2021 Contribution eligible for credit Credit TIMES (X) .10 = For credits earned through an S-Corporation, LLC, or Partnership, enter name and FEIN of the entity If credits from more than one business entity, fill out a separate IN-119 for each entity. Column A Earned in 2021 Column B Carryforward Column C PLUS (+) EQUALS (=) Schedule IN-119 Page 2 of 2 Rev. 10/21

Name of Entity FEIN *211191200* * 2 1 1 1 9 1 2 0 0 *

Taxpayer’s Last Name Social Security Number 5454 2. Charitable Housing (32 V.S.A. § 5830c). . . . . . . . . . . . . 2A. ________________.00 2B. ________________.00 2C. ________________.00 3. Qualified Sale of Mobile Home Park (32 V.S.A. § 5828). . . . . . . . . . . . . . 3A. ________________.00 3B. ________________.00 3C. ________________.00 4. Research & Development (32 V.S.A. § 5930ii). . . . . . . . . . . . . 4A. ________________.00 4B. ________________.00 4C. ________________.00 Prior approval required from Vermont Housing Finance Agency for Line 5 5. Affordable Housing (32 V.S.A § 5930u). . . . . . . . . . . . . . 5A. ________________.00 5B. ________________.00 5C. ________________.00 6. Historic Rehabilitation (32 V.S.A. § 5930cc(a)) . . . . . . . . . . 6A. ________________.00 6B. ________________.00 6C. ________________.00 7. Facade Improvement (32 V.S.A. § 5930cc(b)). . . . . . . . . . 7A. ________________.00 7B. ________________.00 7C. ________________.00 8. Code Improvements (32 V.S.A. § 5930cc(c)). . . . . . . . . . 8A. ________________.00 8B. ________________.00 8C. ________________.00 9. ADD Column C, Lines 1 through 8. If no credit claimed on Line 10, enter this amount on Form IN-111, Line 18 . . 9. ________________.00 Tax Credit Calculation Worksheet 10. Vermont Entrepreneur’s Seed Capital Fund (32 V.S.A. § 5830b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10. ________________.00 11. Enter adjusted Vermont income tax amount from Form IN-111, Line 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11. ________________.00 12. Enter credit for income tax paid to another state or Canadian province from Form IN-111, Line 17 . . . . . . . . . . . . . . .12. ________________.00 13. SUBTRACT Line 12 from Line 11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13. ________________.00 14. Enter the lesser of Line 9 or Line 13. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14. ________________.00 15. SUBTRACT Line 14 from Line 13. The result cannot be less than zero . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15. ________________.00 16. MULTIPLY Line 15 by 50% (0.50). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16. ________________.00 17. Enter the lesser of Line 10 or Line 16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17. ________________.00 18. Total Credits Allowable. ADD Lines 14 and 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18. ________________.00 19. Total Income Tax Credits Available. Enter the lesser of Line 13 or Line 18. Enter this amount on Form IN-111, Line 18. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19. ________________.00 Clear ALL fields Save and go to Important Printing Instructions Save and Print

Schedule IN-153 Page 1 of 2 Rev. 10/21 INCLUDE WITH FORM IN-111 Please PRINT in BLUE or BLACK INK Vermont Department of Taxes 2021 Schedule IN-153 Vermont Capital Gain Exclusion Calculation *211531100* * 2 1 1 5 3 1 1 0 0 *

Taxpayer’s Last Name First Name MI Taxpayer’s Social Security Number 5454 PART I. FLAT EXCLUSION 1. Enter smaller of Line 15 or 16 from federal Form 1040, Schedule D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. _________________________ .00 2. Enter amount from:

2a. Federal Form 1040, Schedule D, Line 18. . . . . . . . . . . 2a. __________________________.00

2b. Federal Form 1040, Schedule D, Line 19. . . . . . . . . . . 2b. __________________________.00 3. Add Lines 2a and 2b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. _________________________ .00 4. Subtract Line 3 from Line 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. _________________________ .00 If you filed federal Form 4952, complete Lines 5 through 7 5. Enter amount from:

5a. Federal Form 4952, Line 4g. . . . . . . . . . . . . . . . . . . . . 5a. __________________________.00

5b. Federal Form 4952, Line 4e. . . . . . . . . . . . . . . . . . . . . 5b. __________________________.00 5c. Multiply Line 5a by Line 5b and enter result here. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5c. _________________________ .00

5d. Federal Form 4952, Line 4b. . . . . . . . . . . . . . . . . . . . . 5d. __________________________.00

5e. Federal Form 4952, Line 4e. . . . . . . . . . . . . . . . . . . . . 5e. __________________________.00 6. Add Lines 5d and 5e; enter result here. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. _________________________ .00 7. Divide Line 5c by Line 6; enter result here . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. _________________________ .00 8. Subtract Line 7 from Line 4. Entry cannot be less than zero. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. _________________________ .00 9. Enter the smaller of Line 8 or $5,000. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. _________________________ .00

Schedule IN-153 Page 2 of 2 Rev. 10/21 *211531200* * 2 1 1 5 3 1 2 0 0 * PART II. PERCENTAGE EXCLUSION (Use this section only if you have eligible gains. See Technical Bulletin 60, Taxation of Gain on the Sale of Capital Assets, for more information or continue on to Part III.) 10. Enter the amount from Part I, Line 4. . . . . . . . . . . . . . . . . . . . . . 10. __________________________.00 11. Enter amount of adjusted net capital gain from the sale of assets held for three years or less. . . . . . . . . . . . . . . . . . . . . . . . . 11. __________________________.00 12. Assets held for more than three years. Subtract Line 11 from Line 10. Entry cannot be less than zero. . . . . . . . . . . . . . . . . . . . 12. __________________________.00 Enter the amount of net adjusted capital gain from the sale of the following assets held for more than three years

13a. Real estate or portion of real estate used as a primary

or nonprimary home. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13a. __________________________.00

13b. Depreciable personal property

(except for farm property or standing timber). . . . . . . . . . 13b. __________________________.00

13c. Stocks or bonds publicly traded or traded on an

exchange or any other financial instruments. . . . . . . . . . . 13c. __________________________.00 14. Add Lines 13a through 13c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. __________________________.00 15. Subtract Line 14 from Line 12; enter result here. Entry cannot be less than zero. This is the amount of net adjusted capital gain eligible for exclusion . . . . . . . . . . . . 15. __________________________.00 Line 16 Federal Form 4952 information. If no investment interest expense for ineligible assets was reported on federal Form 4952, enter Line 7 from Part I of this form. Otherwise, you may need to recompute Form 4952 to reflect only investment interest income for assets eligible for the capital gain exclusion. 16. Enter amount from Part I, Line 7 or recomputed federal Form 4952. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. __________________________.00 17. Subtract Line 16 from Line 15. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. _________________________ .00 18. Multiply Line 17 by 40%; enter result or $350,000, whichever is less. . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. _________________________ .00 PART III. CAPITAL GAIN EXCLUSION 19. Enter the greater of Line 9 or Line 18. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. _________________________ .00 20. Multiply _________________________ x 40% and enter result here. . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. _________________________ .00 Federal Taxable Income 21. Enter the smaller of Line 19 or Line 20. This is your capital gain exclusion. Enter on Schedule IN-112, Part I, Line 8. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. _________________________ .00

Taxpayer’s Last Name Social Security Number 5454 Clear ALL fields Save and go to Important Printing Instructions Save and Print

DEPARTMENT OF TAXES This booklet includes forms and instructions for: IN-111, IN-112, IN-113, IN-116, HS-122, RCC-146, HI-144 2021 VERMONT Income Tax Return Booklet Forms and Instructions For Residents, Part-Year Residents & Nonresidents File by April 18: • Income Tax Return • Homestead Declaration • Property Tax Credit • Renter Credit Claim • Extension to File WHERE’S MY REFUND? Check the status of your refund at myVTax.vermont.gov. For more information about refunds, visit tax.vermont.gov/individuals/refund Business Hours M-F, 7:45 a.m. to 4:30 p.m.

Please note that walk-in restrictions are in place and subject to change due to the COVID-19 pandemic. Phone M, T, Th, F, (802) 828-2865 (866) 828-2865 (toll-free in Vermont) Email tax.individualincome@vermont.gov Address

133 State Street Montpelier, VT 05633-1401

2 tax.vermont.gov Your Contribution Matters Use your tax refund or tax payment to support these Vermont organizations. Enter the amount of your gift on Form IN-111, Vermont Income Tax Return, Line 23a through 23d. You may contribute to more than one organization. You may deduct the above charitable contributions on next year’s personal income taxes. See the instructions for Form IN-111. Together we saved the loon. Let’s not stop now! Other animals like bats and bald eagles are still at risk. Your donation helps protect Vermont’s endangered wildlife for future generations to enjoy. Every $1 you give means an extra $2 helping Vermont’s wildlife. vtfishandwildlife.com (802) 828-1000 Give to our 42,000 honorably discharged veterans. The fund helps veterans who are homeless, need long-term care, or need transportation. It also helps veterans apply for benefits and supports recognition programs. veterans.vermont.gov (802) 828-3379 Vermont Veterans Fund Keep Vermont green and clean! Your gift supports Green Up Day, always the first Saturday in May, where the community comes together to pick up roadside litter and restore the natural beauty of our state. Your generosity makes a difference! greenupvermont.org (802) 229-4586 Support prevention programs for children in your community, including afterschool care, mentoring, teen leadership, literacy, arts, theater programs, substance abuse prevention, and more. We believe these programs are a cost effective approach to improving the well-being and success of Vermont children. vtchildrenstrust.org (888) 475-5437

3 tax.vermont.gov Volunteer Income Tax Assistance (VITA) & Tax Counseling for the Elderly (TCE) Programs

Free tax help is available through VITA to the elderly and those with 1) lower incomes, 2) disabilities, or 3) limited English. TCE focuses on those age 60 years and older. The IRS sponsors both programs. Find a VITA/TCE location nearest you at www.irs.gov. Search for “Free tax help.” AARP Foundation Tax-Aide Program

AARP provides tax assistance sites to taxpayers with low and moderate incomes, giving special attention to those 50 years and older. Find the Tax-Aide location nearest you at www.aarp.org. Search for “Tax Aide.” MyFreeTaxes Partnership

The partnership offers free federal and Vermont filing assistance for qualified individuals.

Are you eligible? Find out at www.myfreetaxes.com. Free Tax Help for Vermonters In 2021, about 200,000 Vermont taxpayers were eligible to e-file their federal and state taxes through Free File — for FREE! Only about 12,000, or about 6%, of those eligible actually used Free File to file their taxes. Are you eligible for Free File? To find out, visit tax.vermont.gov/free-file

4 Lifeline Program Lifeline is a federal program that may provide eligible households with a monthly discount on either phone or internet service. Only one discount is allowed per household. Eligibility To be eligible, you must: 1. Live in Vermont 2. Get your phone or internet service through a participating provider AND 3. Qualify based on either household income or public benefits.

Either: a. Your household income is at or below 135% of the federal poverty level OR b. Someone in your household is getting one of these benefits: • 3SquaresVT • Federal Public Housing Assistance • Medicaid • Supplemental Security Income (SSI) • Veterans Pension/Survivors Pension Application Process • If you already get Lifeline, USAC will check to confirm you still qualify for the benefit. If USAC can confirm you still qualify, there is nothing else that you need to do. • If USAC cannot confirm you still qualify, you will receive a letter in the mail to help you recertify. You may also receive additional reminders by mail or pre-recorded messages on your phone. • If you don’t already get Lifeline, you need to apply through the National Verifier to see if you qualify and then sign up with a Lifeline service provider. Or you can sign up with a Lifeline phone or internet provider directly. Learn More The Universal Service Administrative Company (USAC) has been contracted by the Federal Communications Commission (FCC) to oversee the Lifeline program across the country. To learn more about Lifeline, income guidelines and approved service providers, you can: • Go to lifelinesupport.org/get-help/ • Call USAC at 1-800-234-9473 (7 days a week, 9:00 a.m. to 9:00 p.m.) • Email LifelineSupport@usac.org • Call Vermont’s Senior Helpline at 1-800-642-5119 if you’re age 60 or older • Contact the Consumer Affairs and Public Information Division of the Vermont Department of Public Service at 1-800-622-4496 or psd.consumer@vermont.gov

5 tax.vermont.gov Taxpayer Assistance Visit Our Website for Forms Not Included in This Booklet We have provided the forms in this booklet that most Vermonters need to file their taxes. All forms are available at tax.vermont.gov. The following forms are not included in this booklet: • IN-117 Vermont Credit for Income Tax Paid to Other State or Canadian Province • IN-119 Vermont Tax Adjustments and Nonrefundable Credits • IN-153 Vermont Capital Gains Exclusion • IN-151 Application for Extension of Time to File Form IN-111. Not required if federal extension was filed and you are not required to submit payment with your extension request. Form # Form Description Initial Due Date Final Date Accepted NOTE: Penalties, interest, and late filing fees may accrue after initial due date. IN-111 2021 Vermont Income Tax Return April 18 IN-151 Application for Extension of Time to File Form IN-111 Vermont Income Tax Return April 18 RCC-146 2021 Renter Credit Claim April 18 Oct. 17 HS-122 2022 Homestead Declaration April 18 Oct. 17 HS-122/HI-144 2022 Property Tax Credit Claim April 18 Oct. 17 2022 Due Dates Taxpayer Advocate The Vermont Department of Taxes offers free, confidential service when a taxpayer encounters difficulty resolving tax issues. The Taxpayer Advocate may be able to help if: • You are experiencing extreme economic hardship from the Department’s action, or • It is taking more than 180 days to resolve your tax issue, or • You have not received a response or resolution to the problem by the date promised by the Vermont Department of Taxes The Taxpayer Advocate will review your situation, help you understand what needs to be done to resolve it, and keep you updated on the progress of your situation. Please note that the Taxpayer Advocate cannot override the provisions of the law or represent taxpayers at Department hearings. To contact the Taxpayer Advocate: Mail: ATTN: Taxpayer Advocate Telephone: (802) 828-6848

Vermont Department of Taxes Fax:

(802) 828-5873

133 State Street Email: tax.taxpayeradvocate@vermont.gov Montpelier, VT 05633-1401

6 tax.vermont.gov Online Options for Filers at myVTax.vermont.gov You can do more online through myVTax. No login required! • File extensions for personal income tax • File Renter Credit Claim (Form RCC-146) • Landlords can complete and submit Landlord Certificate (Form LRC-140) • File the Homestead Declaration and Property Tax Credit (Form HS-122/HI-144) • View account status and balances • Set up third party access for your tax preparer • Respond to correspondence • Access “Where’s My Refund?” service to view information on your return and refund status • Check your estimated payments and carryforwards • Make payments via ACH Debit electronic payments for personal income tax • File and pay Property Transfer Tax • Enter into a payment plan Please note: To e-file your IN-111 and associated schedules, you must use a commercial software vendor. If you are eligible, you may file for free using one of Vermont’s Free File vendors. For eligibility guidelines, visit tax.vermont.gov/free-file. Be on Guard against Identity Theft and Tax Scams Identity theft, tax refund fraud, and similar tax scams continue to target taxpayers in Vermont. Taxpayers have reported emails and phone calls from people posing as employees of the Internal Revenue Service (IRS) and the Vermont Department of Taxes. Some scammers are clever enough to pose as their victims’ tax preparers to obtain private information. A common ploy scammers use is to falsely claim taxes are owed and demand immediate payment using threats and bullying. Scammers often target the elderly using these tactics. How to protect yourself from becoming a victim • Never give out personal information unless you are sure of the identity of the person requesting it. • If you suspect that an email or phone call is fraudulent, do not engage in conversation. Contact the Department at (802) 828-2865 or 1-866-828-2865 (toll-free) to verify an email or phone call. How to report fraud • Report suspected fraud immediately to the Vermont Department of Taxes and the IRS. Information about how to report fraud is available on the Department website at tax.vermont.gov/identity-theft. • Suspected fraud also should be reported to the Vermont Attorney General’s Consumer Assistance Program at 1-800-649-2424 (toll-free).

7 tax.vermont.gov General Instructions Requirement to File a Vermont Income Tax Return

A 2021 Vermont Income Tax Return must be filed by all full-year or part-year Vermont residents or a nonresident if you are required to file a 2021 federal income tax return, AND • You earned or received more than $100 in Vermont income, OR • You earned or received gross income of more than $1,000 as a nonresident. Read Vermont law at 32 V.S.A. § 5861 and § 5823(b) for information on sources of income.

Visit our website for more information. Due Date

The 2021 Vermont Income Tax Return must be filed by April 18, 2022. Timely Filing

Tax returns mailed through the U.S. Post Office are considered to be submitted on time if we receive them at the Department within three business days after the due date. Electronic filings transmitted on the due date are on time if the Department receives them by midnight of the due date. Late Filing Penalty and Interest after the April Due Date

A Vermont income tax return can be filed up to 60 days after April 18, 2022, even if you have not filed an extension of time to file. However, if you file the return on the 61st day after the due date or later, the Department will assess a $50 late file penalty. Late payment penalty and interest accrue after the April 18th due date. Filing an Extension for the Vermont Income Tax Return

If a federal extension was filed, you are no longer required to file a separate extension with the State of Vermont. However, if you are making an extension payment, you must file Form IN-151 with your payment. An extension only allows additional time to file your income tax return. It does not extend the due date for your tax payment. Interest and penalty accrue on any tax due from April 19 to the date the Department receives your payment of tax. Extensions can be filed online at myVTax.vermont.gov.

Due dates: Extension requiring payments must be filed by April 18, 2022.

Extended returns must be filed by Oct. 17, 2022.

NOTE: There is no extension of time to file a homestead declaration or property tax credit. Late Filing Penalty and Interest after the Extended Due Date

If you have filed an extension but do not file by the Oct. 17, 2022, extended due date, the Department will charge a $50 late file penalty. Late payment penalty and interest accrue after the April due date. NOTE: The late filing penalty applies regardless if you have a refund or no tax is due. If any tax is due and is not paid by the April 18 due date, late payment penalty and interest charges also apply. Incomplete Forms

If information necessary to support the request for a credit is missing, your filing may be processed but the credit denied. This may result in a bill or reduced refund. The Department will send you a letter requesting the missing information and give you an opportunity to supply what we’ve requested. The credit will not be processed until the Department receives the missing document(s) or information. Forms That Cannot Be Processed

If your filing is not acceptable for processing, the Department will notify you by letter, and you will be required to submit it again. The date you resubmit the forms becomes the filing date of your return. The Department may assess a $25 processing fee to partially cover the cost of taking steps to notify you in addition to our normal processing procedures. Examples of unacceptable filings include, but are not limited to, the following: forms marked “draft” or “do not file,” forms not pre-approved by the Department, photocopies of forms, reduced or enlarged forms, faxed forms, forms not written in blue or black ink, forms generated from different sources, or returns emailed to the Department. Homestead Declaration

Under Vermont law, every Vermont resident whose property meets the definition of a “homestead” must file a Homestead Declaration annually. A homestead is the principal dwelling and parcel of land surrounding the dwelling. It is your responsibility as the property owner to claim the property as a homestead if you meet, or expect to meet, the following requirements: 1) you are a Vermont resident, and 2) you own and occupy a homestead as your domicile as Use Whole Dollars Round entries to the nearest whole dollar. The cents are preprinted with zeroes. Use Only Blue or Black Ink on Paper Forms If you are completing a paper form, use only blue or black ink. Please print legibly. If the Department cannot read your forms, we will not process them and they will be considered unfiled. You will receive a letter to refile. Then, you must resubmit properly completed, legible returns. See “Forms That Cannot Be Processed” below for more information.

8 tax.vermont.gov of April 1, 2022. NOTE: If you meet these requirements but your homestead is leased to a tenant on April 1, 2022, you may still claim it as a homestead if it is not leased for more than 182 days in the calendar year. For definitions of “domicile,” “resident,” and “nonresident,” see our website.

Due date: The Homestead Declaration must be filed by April 18, 2022, to avoid penalties for late filing. Property Tax Credit Claim

Vermont homeowners may be eligible for a credit against their 2022/2023 Vermont property tax. The 2022 Property Tax Credit is based on 2021 household income and 2021/2022 property taxes. A homeowner may be eligible for a credit if all four of the following requirements are met: 1. Filed a valid Homestead Declaration 2. Domiciled in Vermont all of calendar year 2021 3. Not claimed as a dependent by another taxpayer for tax year 2021 4. Had household income in 2021 up to $136,900 (Determine household income by completing Schedule HI-144.)

Due date: The Property Tax Credit Claim due date is April 18, 2022 but may be late filed up to Oct. 17, 2022 with penalty for late file. Renter Credit Claim

Vermont renters may be eligible for a credit for the portion of rent paid that exceeds an established income percentage, based on data provided by the U.S. Department of Housing and Urban Development (HUD). A renter may be eligible for a credit if all three of the following requirements are met: 1. Domiciled in Vermont for the entire calendar year 2021 2. Not claimed in 2021 as a dependent of another taxpayer 3. Rented in Vermont for at least six months in 2021.

Due date: The Renter Credit Claim due date is April 18, 2022 but can be late filed up to Oct. 17, 2022 with no penalty for late filing. Frequently Asked Questions I received a request for more information. Did I do something wrong?

We may ask you to supply additional information to explain items on your Vermont income tax return. A request for more information does not necessarily mean that you filed improperly or that you have been selected for an audit. This type of request is a routine part of processing. It is important that you respond promptly with the requested information. Your return cannot be processed until the Department receives the information requested. For faster processing time, you may submit the requested information at myVTax.vermont.gov. Can my refund be taken to pay another debt?

Your income tax refund will be taken to pay a bill that you or your spouse/civil union partner owe to the Vermont Department of Taxes and/or other government agencies such as the Internal Revenue Service, Office of Child Support, Department of Corrections, Vermont courts, student loan agencies, Vermont state colleges, and tax agencies of other states. This is known as an “offset.” We will notify you in writing if your refund is used as an offset to pay an outstanding debt. Am I responsible for a tax debt owed by my spouse/civil union partner?

If you file a joint return with your spouse/civil union partner and believe tax debt owed by your spouse/civil union partner may reduce your portion of the refund, you may file an “injured spouse” claim. For more information, visit tax.vermont.gov/individuals/injured-spouse.

To make an injured spouse claim when filing a paper return, please send the following documents before you file your return: 1. A signed letter with details of your claim 2. Copy of federal Form 8379 (if you filed one with the IRS) 3. Copies of federal Schedules C and SE (if you filed one with the IRS) 4. Form 1099G for unemployment if received in 2021

Mail to: ATTN: Injured Spouse Unit

Vermont Department of Taxes

PO Box 1645

Montpelier, VT 05601-1645

9 tax.vermont.gov I cannot pay my tax debt due to financial difficulties. What can I do?

If you cannot pay your entire Vermont income tax due, file your return on time and pay as much as you can. Once the Department has issued the first notice of intent to assess for underpayment of tax you may apply for a payment plan on myVTax.vermont.gov or you can write the Department to apply for a payment plan.

Mail to: ATTN: Compliance

Vermont Department of Taxes

PO Box 429

Montpelier, VT 05601-0429

Do not include your written request with your return.

We may ask you for financial information to determine the appropriate payment plan. Without a payment plan, unpaid income tax will result in collection action which may include the imposition of liens, court action, wage garnishment, bank levies, revocation of your business and/or professional license(s), imposition of a bond on your authority to do business, and the assignment of your debt to a private collection agency. How do I claim a refund on my Vermont withholding or estimated tax payments?

You must file a Vermont Income Tax Return to claim a refund of Vermont withholding or estimated tax payments. You have up to three years from the due date of the return, including extensions, to file a claim for overpayment of tax due. How do I correct a mistake or add information to my Vermont Income Tax Return?

You are required to file an amended Vermont return within 60 days of the following: 1) you become aware of a change to your Vermont income; 2) you file an amended return with the IRS; or 3) you receive a notice of change from the IRS.

Check the “AMENDED” box on Form IN-111 when filing an amended return for the applicable tax year. Please include the following documents with your amended return: 1. A copy of federal Form 1040X, Amended U.S. Individual Income Tax Return 2. Your amended federal Form 1040, U.S. Individual Income Tax Return, with all schedules 3. Your amended Vermont Form IN-111 with all schedules even if there is no change on the schedules

NOTE: If you filed a Property Tax Credit Claim, you must also amend your income on Schedule HI-144, Household Income. Income Tax Form Instructions FORM IN-111 Vermont Income Tax Return Taxpayer Information REQUIRED entries.

Print your information in blue or black ink on all forms and schedules being filed. For best results, file electronically or complete the fillable PDF available on our website. If you are mailing in your return, please provide a complete copy of your federal Form 1040, U.S. Individual Income Tax Return, as filed with the IRS along with all schedules. If filing jointly, you must enter the name and Social Security Number of your spouse/civil union partner. Deceased Taxpayer

Check the applicable box if the taxpayer or spouse/civil union partner died during 2021. Mailing Address

Use the address where you receive mail from the United States Post Office. If the mailing address on your return is incorrect and the Department requires additional information, this will delay the processing of your return and your refund until we receive a valid mailing address. If you move after you submit your income tax return, please change your address with the Department as soon as possible. See our website to learn how to change your mailing address. 911 Address

Enter your 911 physical street address as of Dec. 31, 2021. We need your physical address, not your mailing address. Vermont School District Code: REQUIRED entry.

School district codes are published in the instructions, or you may find them on our website. • Vermont residents: Use the 3-digit school district code for your residence on Dec. 31, 2021. • Nonresidents: Enter 999 as your school district code. Health Care Coverage Reporting Requirement

Enter the corresponding number that represents the amount of health care coverage that was maintained throughout tax year 2021. • Enter “1” if you maintained essential health care coverage for yourself throughout all of tax year 2021. • Enter “2” if only your spouse maintained minimum essential health care coverage throughout all of tax year 2021.

10 tax.vermont.gov • Enter “3” if you and your spouse maintained minimum essential health care coverage throughout all of tax year 2021. • Enter “4” if neither you nor your spouse maintained minimum essential health care coverage throughout all of tax year 2021. Recomputed Federal Return

Check the recomputed federal return check box if a recomputed federal return was used to file Form IN-111. NOTE: Taxpayers filing with a recomputed federal return must provide a copy of the original return as filed with the IRS in addition to a copy of the recomputed federal return.

Administrator or Executor: To claim an income tax refund on behalf of the decedent, attach the Certificate of Appointment issued by the Probate Court OR a copy of a completed federal Form 1310, Statement of Person Claiming Refund Due a Deceased Taxpayer. Extended Return

Check the box if you filed for an automatic extension of time to file your federal individual income tax return or if you have filed a Vermont application for extension of time to file using Vermont Form IN-151. An extension of time to file does not extend the time for you to pay the tax due. Any tax due must be paid by the original due date of the return. Any tax due which is unpaid by the original due date will accrue interest and late payment penalties. Tax Filing Information Filing Status REQUIRED entry.

Check the box to show your Vermont filing status. When filing separately, enter the Social Security Number of your spouse/civil union partner in the spouse section of the return. The Vermont filing status must be the same as your federal filing status except in the following two situations where federal information may be recomputed for Vermont purposes: 1. Civil Union (available to same sex couples holding valid civil union certificates): Recomputed federal income tax information required. 2. Only one spouse has sufficient nexus to Vermont subject to Vermont’s tax jurisdiction. “Sufficient nexus” means when a spouse has worked in Vermont at least 183 days. Recomputed federal income tax information may be used. Read Technical Bulletin TB-55, Exceptions to Requirement That Vermont Filing Status Must Mirror Federal Filing Status, on our website. If you choose to file your Vermont Income Tax Return as “Married Filing Jointly,” you cannot use Schedule IN-113, Vermont Income Adjustment Calculations, Part I, to apportion income of the nonresident spouse. The credit for income tax paid to another state is available by completing Schedule IN-117, Vermont Credit for Income Tax Paid to Other State or Canadian Province. Taxable Income Line 1 Adjusted Gross Income REQUIRED entry. Enter the amount from your federal Form 1040 or, if applicable, from the recomputed federal Form 1040. This can be a negative. Use a hyphen (“-”) to indicate negative amounts. Line 2 Net Modifications to Federal Adjusted Gross Income. Enter the amount from Vermont Schedule IN-112, Vermont Tax Adjustments and Credits, Part I, Line 17. This can be a negative. Use a hyphen (“-”) to indicate negative amounts. Line 3 Federal Adjusted Gross Income with Modifications. Add Lines 1 and 2. This can be a negative. Use a hyphen (“-”) to indicate negative amounts. Line 4 2021 Vermont Standard Deduction. Enter the amount of standard deduction from the chart below. You also receive an additional deduction of $1,050 for each standard deduction box checked on the federal Form 1040. If you or your spouse was born before Jan. 2, 1957, or you were blind, use the number of standard deduction boxes checked on your federal Form 1040, select the corresponding number to the filing status and enter on Line 4.

1 2 3 4

7,400 8,450 n/a n/a

13,750 14,800 15,850 16,900

7,400 8,450 9,500 10,550

10,550 11,600 n/a n/a Standard Single 6,350 Married Filing Jointly or Qualifying Widow(er) 12,700 Married Filing Separately 6,350 Head of Household 9,500 For those born before Jan. 2, 1957 or blind OR Personal Exemptions Line 5a Yourself. You may enter “1” on this line if no one can claim you as a dependent on a 2021 personal income tax return. Line 5b Spouse or Civil Union Partner. You may enter “1” on this line as long as no other person can claim your spouse or civil union partner as a dependent on a 2021 personal income tax return. Do not enter “1” if your filing status is Qualifying Widow(er) or Married Filing Separately. Line 5c Other Dependents. Enter the number of dependents other than yourself or spouse that you are claiming on your 2021 federal Form 1040.

11 tax.vermont.gov Line 5d Personal Exemptions. Add Lines 5a through 5c. Line 5e Vermont Personal Exemption Deduction. Multiply Line 5d by $4,350. Line 6 Vermont Standard Deduction plus Personal Exemptions. Add Lines 4 and 5e. Line 7 Vermont Taxable Income. Line 3 minus Line 6. If less than zero, enter -0-. Line 8 Vermont Income Tax. Taxpayers who have a federal Adjusted Gross Income (AGI) greater than $150,000 must pay a minimum Vermont tax of 3% of federal AGI. If your federal AGI, Line 1, is greater than $150,000, enter the amount that is higher: 1) 3% of your federal AGI less interest from U.S. obligations, or 2) tax calculated on Vermont Taxable Income, Line 7, using the applicable tax table or rate schedule.

If your federal AGI, Line 1, is less than or equal to $150,000, calculate your Vermont tax on Vermont Taxable Income, Line 7, using the applicable tax table or rate schedule and enter the result. Line 9 Net Adjustment to Vermont Tax. Compute and submit Vermont Schedule IN-119, Vermont Tax Adjustments and Nonrefundable Credits, Part I, to report:

Additions to Vermont Income Tax • Recapture of a Vermont tax credit OR • 24% of additional federal tax on the following: - Qualified Retirement Plan distributions including IRA, HSA & MSA - Recapture of federal Investment Tax Credit - Lump-sum Distribution from federal Form 4972

Subtractions from Vermont Income Tax • Credit for Child and Dependent Care Expenses (See Schedule IN-112, Part II, to apply for Low-Income Child and Dependent Care Credit.) • Credit for the Elderly or the Disabled • Investment Tax Credit (as defined in IRC Section 46) for Vermont-based portion only • Farm Income Averaging Credit Line 10 Vermont Income Tax with Adjustments. Add Lines 8 and 9. If less than zero, enter -0-. Vermont Charitable Contribution Credit

This nonrefundable credit is available to all taxpayers of this state regardless of whether they elect to itemize at the federal level. The tax credit is equal to 5% of the first $20,000 of charitable contributions made during the taxable year that are allowed under 26 U.S.C. § 170. You may be asked to provide supporting documentation: statements from the qualified charitable organization. Line 11 Tax Deductible Charitable Contribution. Enter the amount contributed to a qualified charity in the taxable year. Line 12 Multiply Line 11 by 5% (0.05). Line 13 Enter the amount on Line 12 or $1,000 ($20,000 times 5%), whichever is less. Line 14 Vermont Income Tax. Line 10 minus Line 13. Line 15 Income Adjustment. Enter 100% or complete and submit Schedule IN-113 and enter percentage from Line 36. Line 16 Adjusted Vermont Income Tax. Multiply Line 14 by the percentage on Line 15. If Line 15 is 100%, Line 16 will be the same as Line 14. Line 17 Credit for Income Tax Paid To Other State or Canadian Province (for full-year and some part-year residents) Complete and submit Schedule IN-117 and enter the amount from Line 21 here. You must submit a separate schedule for each state or province for which you are claiming a credit. Line 18 Vermont Tax Credits. Complete and submit Schedule IN-119, Part II. Enter the amount from Line 9 or 19 here. Line 19 Total Vermont Credits. Add Lines 17 and 18 and enter result. Line 20 Vermont Income Tax After Credits. Subtract Line 19 from Line 16. If Line 19 is more than Line 16, leave this line blank. Line 21 Use Tax on Online, Phone, and Out-of State Purchases.

Complete the Use Tax Worksheet to calculate the amount to report on Line 21. What is Use Tax?

When a seller does not charge the buyer Vermont Sales Tax on an item taxable in Vermont, the buyer must pay Vermont Use Tax. Non-taxable items such as food and clothing are excluded. Taxable items sold over the internet, by mail-order, by phone, or bought out-of-state and used in Vermont generally qualify. Use tax applies whether you are a resident or nonresident. The use tax rate is the same as the sales tax rate: 6%.

12 tax.vermont.gov

If you didn’t keep records of qualifying purchases, Vermont offers an option for estimating them in Part 1. If you did keep records, you should use Part 2. The total for any purchases that cost over $1,000 each needs to be reported on Line 3a.

Please note: Act 73 of 2017 requires vendors to report certain transactions on which no sales tax was paid to the Vermont Department of Taxes. Included in these reports is buyer information which will be used in compliance efforts.

Note: Businesses must report use tax on Form SUT-451, Sales and Use Tax Return, or on Form SU-452, Use Tax Return. Individuals may also use Form SU-452 or use this worksheet. Do not include purchases already reported on those forms on this worksheet. To determine whether items purchased are subject to use tax, please refer to the Department website at tax.vermont.gov. Line 22 Total Vermont Taxes. Add Lines 20 and 21 and enter result. Voluntary Contributions

Learn more about voluntary contributions to these organizations in Vermont in the instructions. Line 23 23a. Vermont Veterans Fund

23b. Green Up Vermont

23c. Nongame Wildlife Fund

23d. Children’s Trust Fund

23e. Add Lines 23a through 23d. Line 24 Total of Vermont Taxes and Voluntary Contributions. Add Lines 22 and 23e. USE TAX WORKSHEET Did you buy taxable items without paying Vermont Sales Tax? This includes orders over the internet, by mail, or by phone on which you did not pay Vermont Sales Tax. This also includes out-of-state purchases on which you paid tax at a rate less than 6%, including purchases of liquor to be consumed in Vermont.

c Yes, but I did not keep accurate records. Go to Part 1.

c Yes, and I kept accurate records. Go to Part 2.

c No. Skip to Part 4. Parts 1 through 3 relate only to the types of purchases described above, where you were not charged at least 6% Sales Tax. Part 1 If you did not keep accurate records 1a. Enter the amount of use tax from the Estimated Use Tax Table below that corresponds to your Adjusted Gross Income from Form IN-111, Line 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a. _______________ 1b. Did you make purchase(s) of $1,000 or more per item?

c Yes. Go to Part 3.

c No. Enter Line 1a amount onto Form IN-111, Line 21 and skip the remainder of this worksheet. Estimated Use Tax Table

Up to $20,000 . . . . . . . . . . . . . . . . $0 $20,001 - $30,000. . . . . . . . . . . . . . . $10 $30,001 - $40,000. . . . . . . . . . . . . . . $15 Adjusted Gross Income Use Tax is: $40,001 - $50,000. . . . . . . . . . . . . . . $20 $50,001 - $60,000. . . . . . . . . . . . . . . $25 $60,001 - $70,000. . . . . . . . . . . . . . . $30 $70,001 - $80,000. . . . . . . . . . . . . . . $35 $80,001 - $90,000. . . . . . . . . . . . . . . $40 $90,001 - $100,000. . . . . . . . . . . . . . . $45 $100,001 and over. . . 0.05% (0.0005) of AGI or $150, whichever is less. Adjusted Gross Income Use Tax is: Adjusted Gross Income Use Tax is: Part 2 If you did keep accurate records 2a. Enter the total amount of all purchases of items under $1,000 each. . . . . . . . . . . . . . . . . . . . . . . 2a. _______________ 2b. Multiply Line 2a by 6% (0.06). Enter the amount here.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b. _______________ Part 3 Total Use Tax due 3a. Enter the total amount of all purchases of items $1,000 or more per item. . . . . . . . . . . . . . . . . . . 3a. _______________ 3b. Multiply Line 3a by 6% (0.06). Enter the amount here.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3b. _______________ 3c. Add Line 3b to either Line 1a or Line 2b (the line with a value entered). . . . . . . . . . . . . . . . . . . . 3c. _______________ 3d. Enter the amount of sales tax paid to another state for the purchases on Lines 2a and 3a, if any. . 3d. _______________ 3e. Line 3c minus Line 3d. Enter here and on Form IN-111, Line 21. . . . . . . . . . . . . . . . . . . . . . . . . 3e. _______________ Part 4 Certification of No Use Tax Due You do not owe use tax if: 1) you did not make any taxable purchases by internet, mail-order, over the phone, or out of state, or 2) you made purchases using any of these methods but paid at least 6% sales tax at the time of purchase on all of them. If one of the situations above is true, check the box next to Line 21 and enter -0- on that line. The failure to pay use tax may result in the assessment of penalties of up to 100% of the unreported tax and interest.

13 tax.vermont.gov Payments and Credits Line 25a 2021 Vermont Tax Withheld From W-2, 1099. Enter the amount of Vermont income tax withheld. Include the state copy of your W-2, Form 1099, or other payment statements to verify the amount. Failure to enter the withholding on this line and attach the payment statement(s) may delay processing of your return, or you may not receive the appropriate credit for the withholding against your Vermont tax.

NOTE: To claim tax withheld on a real estate sale, use Line 25d. Nonresident partners, members, or shareholders, use Line 25e for estimated taxes paid on your behalf by a business entity. Line 25b 2021 Estimated Tax payments, amount carried forward from 2020, and payment made with 2021 extension. Enter the amount of 2021 Vermont estimated income taxes you paid, the amount paid with Form IN-151, Extension of Time to File the 2021 return, and any 2020 Vermont refund credited towards your 2021 taxes. Go to myVTax.vermont.gov to review the 2021 tax payments the Department has on record for you. If you are filing with your spouse or civil union partner, remember to look under both social security numbers.

NOTE: Nonresident partners, members or shareholders, use Line 25e for estimated taxes paid on your behalf by a business entity. For tax withheld on real estate transactions, use Line 25d. Line 25c Refundable Credits. (Schedule IN-112, Vermont Tax Adjustments and Credits, Part II)

Low Income Child and Dependent Care Credit (for full-year Vermont residents)

Vermont Earned Income Tax Credit (for full-year and part-year Vermont residents) Enter the amount from Schedule IN-112, Part II, Line 11. Attach the completed Schedule IN-112 to Form IN-111. Line 25d Vermont Real Estate Withholding from Form RW-171. If you sold real estate in Vermont during 2021 and the buyer withheld Vermont income tax from the sales price, enter the amount withheld shown on Form RW-171, Vermont Withholding Tax Return for Transfer of Real Property, Schedule A, Line 12. Do not enter this amount on Line 25a or 25b. For information on installment sales, read Technical Bulletin TB-10, Installment Sales of Real Estate, on our website. Line 25e Estimated Payments Made on Your Behalf by a Business Entity from Schedule K-1VT, Line 5. Nonresidents enter the estimated income tax payments made on your behalf by a partnership, limited liability company, or S Corporation toward your 2021 Vermont income tax. The entity reports these payments to you on Schedule K-1VT, Vermont Shareholder, Partner, or Member Information, Line 5. Read Technical Bulletin TB-06, Estimated Payments by S Corporation, Partnerships, and Limited Liability Companies on Behalf of Shareholders, Partners and Members, on our website. Do not enter this amount on Line 25a or 25b. Line 25f Total Payments and Credits. Add Lines 25a through 25e. Refund Line 26 Overpayment. If Line 24 is less than Line 25f, you are due a refund. Subtract Line 24 from Line 25f and enter the result here. You may apply all or a portion of the overpayment towards your 2022 estimated payment or your 2022/2023 Vermont homestead property tax bill. Line 27a Credit to 2022 Estimated Tax Payment. Enter the amount of your refund from Line 26 that you want credited toward your 2022 income tax. Any amount reported on this line will be deducted from your total refund amount. Line 27b Credit to 2022/2023 Homestead Property Tax Bill. If your property is a declared homestead and you filed the 2021 income tax return on or before Oct. 17, 2022, you may choose to use all or part of your income tax refund to pay your homestead property tax bill. Any amount reported on this line will be deducted from your total refund amount. The state will include an additional 1% to the amount of the refund that is credited to your property taxes. For details of this credit, read “State Property Tax Incentive” in Vermont law at 32 V.S.A. § 6066(h). Line 28 Refund Amount. Subtract the sum of Lines 27a and 27b from Line 26 and enter the result. This is the amount of the refund to be sent to you. If you owe interest and penalty for underpayment of estimated income tax payment, this amount will be subtracted from the refund. Direct deposit is available for most electronically filed returns. All paper filed returns with refund requests will receive a paper check. Amount You Owe Line 29 If Line 24 is more than Line 25f, subtract Line 25f from Line 24 and enter the result. Line 30 Interest and Penalty on Underpayment of or Failure to Make Estimated Tax Payments. Paying underpayment charges at the time of filing may reduce the amount that will be billed later. To calculate the charges, use Worksheet IN-152, Underpayment of 2021 Estimated Individual Income Tax, or Worksheet IN-152A, Annualized Income Installment Method for Underpayment of 2021 Estimated Tax by Individuals, Estates, and Trusts. Both worksheets are available on our website. The paper worksheets can be obtained by calling (802) 828-2515. If you have a refund, the underpayment, interest, and penalty will be deducted. Estimated tax payments must either be: 1) equal to 100% of last year’s tax liability OR 2) 90% of this year’s tax liability. If the tax liability due, less withholding, is less than $500, you will not be subject to penalty or interest charges. In order to avoid underpayment of estimated tax, see instructions on Form IN-114, Individual Income Estimated Tax Payment Voucher. NOTE: If you owe taxes or a debt to another state agency, all or part of the refund may be taken to pay the bill.

14 tax.vermont.gov Line 31 Total. Add Lines 29 and 30. Enter the amount. This is the amount you owe.

Electronic payment options available at myVTax.vermont.gov:

- ACH debit (no fee)

- Credit or Debit card (3% service fee applies)

You may also pay by check or money order payable to the Vermont Department of Taxes. Please include 2021 Form IN-116, Vermont Income Tax Payment Voucher, with your payment. Signatures REQUIRED entry. Sign the return in the space provided. If filing your return jointly, both filers must sign. NOTE: Failure to sign your return may delay the processing of your return. Date Enter the date on which you sign the return. Date of Birth Enter your date of birth. Telephone Number Enter the number where you can be reached during the day. Disclosure Authorization If you wish to authorize the Department to discuss the information on your 2021 Vermont income tax return with your tax preparer, check this box and include the preparer’s name. This authorization will automatically end April 18, 2027. Preparer If you are a paid preparer, you must also sign the return, enter your Social Security Number or PTIN, and, if employed by a business, the Federal Employer Identification Number (FEIN) of the business. FILING THE RETURN E-file: Go to our website for information on electronic filing. Some taxpayers may be eligible for free electronic filing through Free File. Paper Filing:

REFUND OR NO TAX DUE

BALANCE DUE

Mail your return to:

Attach your check to the lower left side of the return and mail to:

Vermont Department of Taxes Vermont Department of Taxes

PO Box 1881

PO Box 1779

Montpelier, VT 05601-1881

Montpelier, VT 05601-1779 FOLLOW THE PROCESSING OF YOUR RETURN

You may check the status of your return by visiting myVTax.vermont.gov and selecting “Check the status of your return.” SCHEDULE IN-112 Vermont Tax Adjustments and Credits Print your name and Social Security Number on this schedule. Please use blue or black ink to make all entries. Who Must File Schedule IN-112

You must file Schedule IN-112 if you: • Have interest income from state and local obligations (Part I) - Federal bonus depreciation - Adjustment to bonus depreciation - Interest Income from U.S. obligations - Capital Gains Exclusion - Taxable refunds of state and local income tax • Are claiming Vermont Refundable Credits (Part II) - Low Income Child & Dependent Care - Vermont Earned Income Tax Credit Part I Additions to Federal Adjusted Gross Income

Interest and dividend income from non-Vermont state and local obligations which are exempted from federal taxable income are taxable in Vermont. A Vermont obligation is one from the state of Vermont or a Vermont municipality. Line 1 Enter the total interest and dividend income received from all state and local obligations exempted from federal tax as reported on federal Form 1040, U.S. Individual Income Tax Return. Line 2 Enter the interest and dividend income from Vermont obligations. This may have been paid directly to you or through a mutual fund or other legal entity that invests in Vermont state and local obligations. If you receive this income from a mutual fund that has only a portion of its assets invested in Vermont state and local obligations, enter only the amount for the Vermont obligation(s). Line 3 Subtract Line 2 from Line 1. This is the amount of interest and dividend income from non-Vermont state and local obligations that must be included in Vermont Taxable Income. For information on payment plans, see “Financial Difficulties” in the General Instructions section.

15 tax.vermont.gov Instructions continued on page 31 SOCIAL SECURITY EXEMPTION WORKSHEET PLEASE READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING THIS WORKSHEET. Instructions: It is important that you answer the questions in Section I to determine if you qualify for a full or partial exemption. If you qualify for a partial exemption, you may move on to Section II to calculate the amount of the exemption. SECTION I: Do you qualify for the Vermont Social Security full or partial exemption? 1. Did you report an amount on federal Form 1040, U.S. Individual Income Tax Return, Line 6b, earning Social Security benefits that were taxable in the current tax year? c No, STOP. You do not qualify for this exemption. c Yes. Proceed to question 2. 2. If you are: • Married filing jointly, is your Adjusted Gross Income (AGI) on Form IN-111, Vermont Income Tax Return, Line 1, less than $70,000? • Single, head of household, qualifying widow(er), or married filing separately, is your AGI on Form IN-111, Line 1, less than $55,000? c No, STOP. You do not qualify for this exemption. c Yes. You qualify for Vermont’s Social Security exemption. Proceed to question 3. 3. If you are: • Married filing jointly, is your AGI less than $60,000? • Single, head of household, qualifying widow(er), or married filing separately, is your AGI less than $45,000? c No. Please proceed to Section II of this worksheet. c Yes. You qualify for a full exemption. Please enter the full amount from federal Form 1040, Line 6b, on Schedule IN-112, Part I, Line 12. SECTION II: Calculating your Social Security Partial Exemption This section is for married joint filers with an Adjusted Gross Income (AGI) between $60,000-$70,000 and for single, head of household, qualifying widow(er), or married separate filers with an AGI between $45,000-$55,000. 4. If you are:

• Married filing jointly, enter $70,000.

• All other filing statuses, enter $55,000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4. ________________ 5. Enter your AGI from Form IN-111, Line 1.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. ________________ 6. Subtract Line 5 from Line 4. If Line 5 is greater than Line 4, enter -0-.. . . . . . . . . . . . . . . . . . 6. ________________ 7. Divide Line 6 by $10,000. This value will be a decimal. Please round to the second decimal place (Example: .481 would round to .48).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. ________________ 8. Enter the lesser of Line 7 or the value 1 (This line should not be greater than 1).. . . . . . . . . . . 8. ________________ 9. Enter the amount from federal Form 1040, Line 6b.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. ________________ 10. Amount of partial exemption. Multiply Line 9 by Line 8. Enter this amount on Schedule IN-112, Part I, Line 12.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. ________________ Note about civil unions: If you are in a civil union and filing jointly, you should file for this exemption as married filing jointly. If you are a civil union and filing separately, you should file as married filing separately. MEDICAL DEDUCTION WORKSHEET 1a. Medical and Dental Expense from federal Form 1040, Schedule A, Line 4. . . . . . . . . . . . . . . 1a. ________________ 1b. Non-allowable expenses included in Line 1a (See instructions below*) . . . . . . . . . . . . . . . . . 1b. ________________ 1c. Total. Line 1a minus Line 1b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1c. ________________ 2. Amount from Vermont Form IN-111, Line 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. ________________ 3. Subtract Line 2 from Line 1c. Enter here and on Schedule IN-112, Part I, Line 11. . . . . . . . . 3. ________________ If amount on Line 3 is negative, STOP. You do not qualify for this deduction. *If you pay recurring monthly payments or entrance fees to a retirement community, these amounts are not deductible. Please enter the fees on Line 1b. Please see our website at tax.vermont.gov for more information.

16 tax.vermont.gov

VT

SCHOOL SCHOOL DISTRICT NAME CODE 001 ADDISON 002 ALBANY 003 ALBURGH 004 ANDOVER 005 ARLINGTON 006 ATHENS 255 AVERILL 256 AVERY’S GORE 007 BAKERSFIELD 008 BALTIMORE 009 BARNARD 010 BARNET 011 BARRE CITY 012 BARRE TOWN 013 BARTON 014 BELVIDERE 015 BENNINGTON 016 BENSON 017 BERKSHIRE 018 BERLIN 019 BETHEL 020 BLOOMFIELD 021 BOLTON 022 BRADFORD 023 BRAINTREE 024 BRANDON 025 BRATTLEBORO 026 BRIDGEWATER 027 BRIDPORT 028 BRIGHTON 029 BRISTOL 030 BROOKFIELD 031 BROOKLINE 032 BROWNINGTON 033 BRUNSWICK 252 BUEL’S GORE 034 BURKE 035 BURLINGTON 036 CABOT 037 CALAIS 038 CAMBRIDGE 039 CANAAN 040 CASTLETON 041 CAVENDISH 042 CHARLESTON 043 CHARLOTTE 044 CHELSEA 045 CHESTER 046 CHITTENDEN 047 CLARENDON 048 COLCHESTER 049 CONCORD 050 CORINTH 051 CORNWALL 052 COVENTRY 053 CRAFTSBURY 054 DANBY 055 DANVILLE 056 DERBY 057 DORSET 058 DOVER 059 DUMMERSTON 060 DUXBURY 061 EAST HAVEN 062 EAST MONTPELIER 063 EDEN

VT

SCHOOL SCHOOL DISTRICT NAME CODE 064 ELMORE 065 ENOSBURG 066 ESSEX JUNCTION 067 ESSEX TOWN 070 FAIR HAVEN 068 FAIRFAX 069 FAIRFIELD 071 FAIRLEE 072 FAYSTON 257 FERDINAND 073 FERRISBURGH 074 FLETCHER 075 FRANKLIN 076 GEORGIA 258 GLASTENBURY 077 GLOVER 078 GOSHEN 079 GRAFTON 080 GRANBY 081 GRAND ISLE 082 GRANVILLE 083 GREENSBORO 084 GROTON 085 GUILDHALL 086 GUILFORD 087 HALIFAX 088 HANCOCK 089 HARDWICK 090 HARTFORD 091 HARTLAND 092 HIGHGATE 093 HINESBURG 094 HOLLAND 095 HUBBARDTON 096 HUNTINGTON 097 HYDE PARK 098 IRA 099 IRASBURG 100 ISLE LA MOTTE 101 JAMAICA 102 JAY 103 JERICHO 253 JERICHO ID 104 JOHNSON 185 KILLINGTON 105 KIRBY 106 LANDGROVE 107 LEICESTER 108 LEMINGTON 259 LEWIS 109 LINCOLN 110 LONDONDERRY 111 LOWELL 112 LUDLOW 113 LUNENBURG 114 LYNDON 115 MAIDSTONE 116 MANCHESTER 117 MARLBORO 118 MARSHFIELD 119 MENDON 120 MIDDLEBURY 121 MIDDLESEX 122 MIDDLETOWN SPRINGS 123 MILTON 124 MONKTON

VT

SCHOOL SCHOOL DISTRICT NAME CODE 125 MONTGOMERY 126 MONTPELIER 127 MORETOWN 128 MORGAN 129 MORRISTOWN 130 MOUNT HOLLY 131 MOUNT TABOR 135 NEW HAVEN 132 NEWARK 133 NEWBURY 134 NEWFANE 136 NEWPORT CITY 137 NEWPORT TOWN 138 NORTH BENNINGTON ID 140 NORTH HERO 139 NORTHFIELD 141 NORTON 142 NORWICH 143 ORANGE 144 ORLEANS 145 ORWELL 146 PANTON 147 PAWLET 148 PEACHAM 149 PERU 150 PITTSFIELD 151 PITTSFORD 152 PLAINFIELD 153 PLYMOUTH 154 POMFRET 155 POULTNEY 156 POWNAL 157 PROCTOR 158 PUTNEY 159 RANDOLPH 160 READING 161 READSBORO 162 RICHFORD 163 RICHMOND 164 RIPTON 165 ROCHESTER 166 ROCKINGHAM 167 ROXBURY 168 ROYALTON 169 RUPERT 170 RUTLAND CITY 171 RUTLAND TOWN 172 RYEGATE 173 SAINT ALBANS CITY 174 SAINT ALBANS TOWN 175 SAINT GEORGE 176 SAINT JOHNSBURY 177 SALISBURY 178 SANDGATE 179 SEARSBURG 180 SHAFTSBURY 254 SHAFTSBURY ID 181 SHARON 182 SHEFFIELD 183 SHELBURNE 184 SHELDON 186 SHOREHAM 187 SHREWSBURY 260 SOMERSET 188 SOUTH BURLINGTON 189 SOUTH HERO

VT

SCHOOL SCHOOL DISTRICT NAME CODE 190 SPRINGFIELD 191 STAMFORD 192 STANNARD 193 STARKSBORO 194 STOCKBRIDGE 195 STOWE 196 STRAFFORD 197 STRATTON 198 SUDBURY 199 SUNDERLAND 200 SUTTON 201 SWANTON 202 THETFORD 203 TINMOUTH 204 TOPSHAM 205 TOWNSHEND 206 TROY 207 TUNBRIDGE 208 UNDERHILL ID 209 UNDERHILL TOWN 210 VERGENNES 211 VERNON 212 VERSHIRE 213 VICTORY 214 WAITSFIELD 215 WALDEN 216 WALLINGFORD 217 WALTHAM 218 WARDSBORO 261 WARNER’S GRANT 219 WARREN 262 WARREN’S GORE 220 WASHINGTON 221 WATERBURY 222 WATERFORD 223 WATERVILLE 224 WEATHERSFIELD 225 WELLS 226 WELLS RIVER 227 WEST FAIRLEE 230 WEST HAVEN 234 WEST RUTLAND 235 WEST WINDSOR 228 WESTFIELD 229 WESTFORD 231 WESTMINSTER 232 WESTMORE 233 WESTON 236 WEYBRIDGE 237 WHEELOCK 238 WHITING 239 WHITINGHAM 240 WILLIAMSTOWN 241 WILLISTON 242 WILMINGTON 243 WINDHAM 244 WINDSOR 245 WINHALL 246 WINOOSKI 247 WOLCOTT 248 WOODBURY 249 WOODFORD 250 WOODSTOCK 251 WORCESTER VERMONT SCHOOL DISTRICT CODES

Homeowners: For Form IN-111, use the school district code where you owned a home and resided last Dec. 31. For Form HS-122, use the school district code where you own a home and reside on April 1 this year.

Renters: Use the school district code where you rented last Dec. 31. Check with your local school officials if you are not sure which code to use. Enter the school district code on Form IN-111 (if you are required to file that form) and Form RCC-146.

Nonresidents: Enter 999 for the school district code on Form IN-111.

1. Federal Adjusted Gross Income (federal Form 1040, Line 11). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. ___________________________ .00 2. Net Modifications to Federal AGI (Schedule IN-112, Part I, Line 17). . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. ___________________________ .00 3. Federal AGI with Modifications (ADD Lines 1 and 2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. ___________________________ .00 4. 2021 Vermont Standard Deduction from filing status section above.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. ___________________________ .00

Please see instructions if you or your spouse checked any standard

deduction boxes on federal Form 1040, page 1. 5. Personal Exemptions:

5a. Enter “1” for yourself if no one can claim you as a dependent . . . . . . . . . . . . . . . . . . . . . . . . . . 5a. ________

5b. Enter “1” for your jointly filed spouse or CU partner if no one can claim them as a dependent or if you are a qualifying widow(er). . . . . . . . . . . . . . . . . . . . . . . . . 5b. ________

5c. Enter number of other dependents claimed on federal Form 1040. This includes any dependents other than yourself and/or your spouse.. . . . . . . . . . . . . . . . . . . . . 5c. ________

5d. ADD Lines 5a through 5c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5d. _ ________ 5e. MULTIPLY Line 5d by $4,350 (2021 Personal Exemption). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5e. ___________________________ .00 6. ADD Lines 4 and 5e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. ___________________________ .00 7. Vermont Taxable Income (SUBTRACT Line 6 from Line 3. If less than zero, enter -0-). . . . . . . . . . . 7. ___________________________ .00 8. Vermont Income Tax from tax table or tax rate schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. ___________________________ .00 (If Line 1 is greater than $150,000, see instructions) 9. Net Adjustment to Vermont Tax (Schedule IN-119, Part I, Line 16). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. ___________________________ .00 10. Vermont Income Tax with Adjustment (ADD Lines 8 and 9. If less than zero, enter -0-). . . . . . . . . . 10. ___________________________ .00

13. ___________________________ .00 14. Vermont Income Tax (Line 10 MINUS Line 13. If less than zero, enter -0-) . . . . . . . . . . . . . . . . . . . 14. ___________________________ .00 15. Income Adjustment (Schedule IN-113, Line 36, or 100.0000%). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15. ________ . _________% 16. Adjusted Vermont Income Tax (MULTIPLY Line 14 by Line 15). . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. _ _____________________________.00 Please PRINT in BLUE or BLACK INK DEPT USE ONLY FILE YOUR RETURN ELECTRONICALLY FOR A FASTER REFUND. GO TO TAX.VERMONT.GOV FOR MORE INFORMATION. 13. Charitable Contribution Deduction (Enter the lesser of Line 12 or $1,000) . . . . . . Form IN-111 Page 1 of 2 Rev. 10/21 Vermont Department of Taxes 2021 Form IN-111 Vermont Income Tax Return Amount Due (from Line 31) .00 ___________ .00 ___________ .00 11. Tax-Deductible Charitable Contribution 12. Multiply Line 11 by 5% (0.05)

(See instructions)

Taxpayer’s Last Name First Name MI Social Security Number

Spouse’s/CU Partner’s Last Name First Name MI Social Security Number

Mailing Address (Number and Street/Road or PO Box) 911/Physical Street Address on 12/31/2021

City State ZIP Code or Foreign Postal Code Foreign Country Vermont School District Code

Check if Deceased Check if Deceased AMENDED Return RECOMPUTED Return Qualifying Widow(er) ($12,700) Head of Household ($9,500) Married/CU Filing Separately ($6,350) Married/CU Filing Jointly ($12,700) Single ($6,350) Filing Status and Standard Deduction Enter Healthcare Coverage Code (See instructions for code options)

EXTENDED Return Check all that apply *211111100* * 2 1 1 1 1 1 1 0 0 * 5454

Keep a copy for your records. Form IN-111 Page 2 of 2 Rev. 10/21 Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct and complete. Preparers cannot use return information for purposes other than preparing returns. Other State Credit (Schedule IN-117, Line 21) Vermont Tax Credits (Schedule IN-119, Part II) Total Vermont Credits (Add Lines 17 and 18) OR Check to certify no Use Tax is due. Check if the Department of Taxes may discuss this return with the preparer shown. For Amended Returns Only:

Original refund received Refund due now Original payment Amount due now .00 .00 .00 .00 Signature Date (MM/DD/YYYY) Date of Birth (MM/DD/YYYY) Daytime Telephone Number Signature (If a joint return, BOTH must sign.) Date (MM/DD/YYYY) Date of Birth (MM/DD/YYYY) Daytime Telephone Number Paid Preparer’s Signature

Date Preparer’s Telephone Number Firm’s Name (or yours if self-employed) and address

Preparer’s SSN or PTIN FEIN / / / / Green Up Vermont Total Contributions Vermont Veterans Fund Children’s Trust Fund Nongame Wildlife Fund / / *211111200* * 2 1 1 1 1 1 2 0 0 * Amount from Line 16 .00

Taxpayer’s Last Name Social Security Number 17. _____________________.00 + 18._____________________ .00 = 19. ___________________________ .00 20. Vermont Income Tax after credits (SUBTRACT Line 19 from Line 16. If Line 19 is greater than Line 16, enter -0-). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. ___________________________ .00 21. Use Tax for taxable items on which no sales tax was charged, including online purchases. (See instructions, worksheet, and chart). . . . 21. ___________________________ .00 22. Total Vermont Taxes (ADD Lines 20 and 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. ___________________________ .00 23a. _________.00 + 23b. _________.00 + 23c. _________.00 + 23d. _________.00 = 23e.____________ .00 24. Total of Vermont Taxes and Voluntary Contributions (ADD Lines 22 and 23e). . . . . . . . . . . . . . . . . . 24. ___________________________ .00 25a. 2021 Vermont Tax Withheld from W-2, 1099. . . . . . . . . . . . . . . . . . . . 25a. ___________________ .00 25b. 2021 Estimated Tax payments, amount carried forward from 2020, and/or payment made with 2021 extension. . . . . . . . . . . . . . . . . . . . . . . 25b. ___________________ .00 25c. Refundable Credits (Schedule IN-112, Part II, Line 11) . . . . . . . . . . . . 25c. ___________________ .00 25d. 2021 Vermont Real Estate Withholding from Form RW-171. . . . . . . . 25d. ___________________ .00 25e. 2021 Nonresident Estimated Tax payments (nonresident withholding) allocated on Schedule K-1VT, Line 5. . . . . 25e. ___________________ .00 25f. Total Payments and Credits (ADD Lines 25a through 25e). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25f. ___________________________ .00 26. Overpayment. If Line 24 is less than Line 25f, SUBTRACT Line 24 from Line 25f. . . . . . . . . . . . 26. ___________________________ .00 27a. Refund to be credited to 2022 Estimated Tax Payment. . . . . . . . . . . . . 27a. ___________________ .00 27b. Refund to be credited to 2022 Property Tax Bill. . . . . . . . . . . . . . . . . . 27b. ___________________ .00 28. REFUND AMOUNT (SUBTRACT Lines 27a and 27b from Line 26). . . . . . . . . . . . . . . . . . . . . . . 28. ___________________________ .00 29. If Line 24 is more than Line 25f, subtract Line 25f from Line 24. See instructions on tax due. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. ___________________________ .00 30. Interest and Penalty on

31. AMOUNT DUE

Underpayment of Estimated Tax. . . 30. _________________.00 (ADD Lines 29 and 30).31. ___________________________ .00 (Worksheet IN-152 or IN-152A) 5454

1. Federal Adjusted Gross Income (federal Form 1040, Line 11). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. ___________________________ .00 2. Net Modifications to Federal AGI (Schedule IN-112, Part I, Line 17). . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. ___________________________ .00 3. Federal AGI with Modifications (ADD Lines 1 and 2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. ___________________________ .00 4. 2021 Vermont Standard Deduction from filing status section above.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. ___________________________ .00

Please see instructions if you or your spouse checked any standard

deduction boxes on federal Form 1040, page 1. 5. Personal Exemptions:

5a. Enter “1” for yourself if no one can claim you as a dependent . . . . . . . . . . . . . . . . . . . . . . . . . . 5a. ________

5b. Enter “1” for your jointly filed spouse or CU partner if no one can claim them as a dependent or if you are a qualifying widow(er). . . . . . . . . . . . . . . . . . . . . . . . . 5b. ________

5c. Enter number of other dependents claimed on federal Form 1040. This includes any dependents other than yourself and/or your spouse.. . . . . . . . . . . . . . . . . . . . . 5c. ________

5d. ADD Lines 5a through 5c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5d. _ ________ 5e. MULTIPLY Line 5d by $4,350 (2021 Personal Exemption). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5e. ___________________________ .00 6. ADD Lines 4 and 5e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. ___________________________ .00 7. Vermont Taxable Income (SUBTRACT Line 6 from Line 3. If less than zero, enter -0-). . . . . . . . . . . 7. ___________________________ .00 8. Vermont Income Tax from tax table or tax rate schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. ___________________________ .00 (If Line 1 is greater than $150,000, see instructions) 9. Net Adjustment to Vermont Tax (Schedule IN-119, Part I, Line 16). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. ___________________________ .00 10. Vermont Income Tax with Adjustment (ADD Lines 8 and 9. If less than zero, enter -0-). . . . . . . . . . 10. ___________________________ .00

13. ___________________________ .00 14. Vermont Income Tax (Line 10 MINUS Line 13. If less than zero, enter -0-) . . . . . . . . . . . . . . . . . . . 14. ___________________________ .00 15. Income Adjustment (Schedule IN-113, Line 36, or 100.0000%). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15. ________ . _________% 16. Adjusted Vermont Income Tax (MULTIPLY Line 14 by Line 15). . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. _ _____________________________.00 Please PRINT in BLUE or BLACK INK DEPT USE ONLY FILE YOUR RETURN ELECTRONICALLY FOR A FASTER REFUND. GO TO TAX.VERMONT.GOV FOR MORE INFORMATION. 13. Charitable Contribution Deduction (Enter the lesser of Line 12 or $1,000) . . . . . . Form IN-111 Page 1 of 2 Rev. 10/21 Vermont Department of Taxes 2021 Form IN-111 Vermont Income Tax Return ___________ .00 ___________ .00 11. Tax-Deductible Charitable Contribution 12. Multiply Line 11 by 5% (0.05)

(See instructions)

Taxpayer’s Last Name First Name MI Social Security Number

Spouse’s/CU Partner’s Last Name First Name MI Social Security Number

Mailing Address (Number and Street/Road or PO Box) 911/Physical Street Address on 12/31/2021

City State ZIP Code or Foreign Postal Code Foreign Country Vermont School District Code

Check if Deceased Check if Deceased AMENDED Return RECOMPUTED Return Qualifying Widow(er) ($12,700) Head of Household ($9,500) Married/CU Filing Separately ($6,350) Married/CU Filing Jointly ($12,700) Single ($6,350) Filing Status and Standard Deduction Enter Healthcare Coverage Code (See instructions for code options)

EXTENDED Return Check all that apply *211111100* * 2 1 1 1 1 1 1 0 0 * Amount Due (from Line 31) .00 5454

Keep a copy for your records. Form IN-111 Page 2 of 2 Rev. 10/21 Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct and complete. Preparers cannot use return information for purposes other than preparing returns. Other State Credit (Schedule IN-117, Line 21) Vermont Tax Credits (Schedule IN-119, Part II) Total Vermont Credits (Add Lines 17 and 18) OR Check to certify no Use Tax is due. Check if the Department of Taxes may discuss this return with the preparer shown. For Amended Returns Only:

Original refund received Refund due now Original payment Amount due now .00 .00 .00 .00 Signature Date (MM/DD/YYYY) Date of Birth (MM/DD/YYYY) Daytime Telephone Number Signature (If a joint return, BOTH must sign.) Date (MM/DD/YYYY) Date of Birth (MM/DD/YYYY) Daytime Telephone Number Paid Preparer’s Signature

Date Preparer’s Telephone Number Firm’s Name (or yours if self-employed) and address

Preparer’s SSN or PTIN FEIN / / / / Green Up Vermont Total Contributions Vermont Veterans Fund Children’s Trust Fund Nongame Wildlife Fund / / *211111200* * 2 1 1 1 1 1 2 0 0 * Amount from Line 16 .00

Taxpayer’s Last Name Social Security Number 17. _____________________.00 + 18._____________________ .00 = 19. ___________________________ .00 20. Vermont Income Tax after credits (SUBTRACT Line 19 from Line 16. If Line 19 is greater than Line 16, enter -0-). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. ___________________________ .00 21. Use Tax for taxable items on which no sales tax was charged, including online purchases. (See instructions, worksheet, and chart). . . . 21. ___________________________ .00 22. Total Vermont Taxes (ADD Lines 20 and 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. ___________________________ .00 23a. _________.00 + 23b. _________.00 + 23c. _________.00 + 23d. _________.00 = 23e.____________ .00 24. Total of Vermont Taxes and Voluntary Contributions (ADD Lines 22 and 23e). . . . . . . . . . . . . . . . . . 24. ___________________________ .00 25a. 2021 Vermont Tax Withheld from W-2, 1099. . . . . . . . . . . . . . . . . . . . 25a. ___________________ .00 25b. 2021 Estimated Tax payments, amount carried forward from 2020, and/or payment made with 2021 extension. . . . . . . . . . . . . . . . . . . . . . . 25b. ___________________ .00 25c. Refundable Credits (Schedule IN-112, Part II, Line 11) . . . . . . . . . . . . 25c. ___________________ .00 25d. 2021 Vermont Real Estate Withholding from Form RW-171. . . . . . . . 25d. ___________________ .00 25e. 2021 Nonresident Estimated Tax payments (nonresident withholding) allocated on Schedule K-1VT, Line 5. . . . . 25e. ___________________ .00 25f. Total Payments and Credits (ADD Lines 25a through 25e). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25f. ___________________________ .00 26. Overpayment. If Line 24 is less than Line 25f, SUBTRACT Line 24 from Line 25f. . . . . . . . . . . . 26. ___________________________ .00 27a. Refund to be credited to 2022 Estimated Tax Payment. . . . . . . . . . . . . 27a. ___________________ .00 27b. Refund to be credited to 2022 Property Tax Bill. . . . . . . . . . . . . . . . . . 27b. ___________________ .00 28. REFUND AMOUNT (SUBTRACT Lines 27a and 27b from Line 26). . . . . . . . . . . . . . . . . . . . . . . 28. ___________________________ .00 29. If Line 24 is more than Line 25f, subtract Line 25f from Line 24. See instructions on tax due. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. ___________________________ .00 30. Interest and Penalty on

31. AMOUNT DUE

Underpayment of Estimated Tax. . . 30. _________________.00 (ADD Lines 29 and 30).31. ___________________________ .00 (Worksheet IN-152 or IN-152A) 5454

PART I ADDITIONS TO FEDERAL ADJUSTED GROSS INCOME 1. Total interest and dividend income from all state and local obligations exempt from federal tax (reported on federal Form 1040). . . . . . . . . . . . . . . . . . . . . . . . . . . 1. __________________________.00 2. Interest and dividend income from Vermont state and local obligations included in Line 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. __________________________.00 3. Income from Non-Vermont State and Local Obligations (SUBTRACT Line 2 from Line 1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. _ _________________________ .00 4. Bonus Depreciation Allowed under Federal Law for 2021. . . . . . 4. __________________________.00 5. Other (reserved) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. __________________________.00 6. Total Additions (ADD Line 3 and Line 4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. _ _________________________ .00 SUBTRACTIONS FROM FEDERAL ADJUSTED GROSS INCOME 7. Interest Income from U.S. Obligations. . . . . . . . . . . . . . . . . . . . . . 7. __________________________.00 8. Capital Gains Exclusion (Schedule IN-153, Line 21) . . . . . . . . . . 8. __________________________.00 9. Adjustment for Prior Years’ Bonus Depreciation. . . . . . . . . . . . . . 9. __________________________.00 10. Taxable Refunds of State and Local Income Taxes (Reported on federal Form 1040). . . . . . . . . . . . . . . . . . . . . . . . . 10. __________________________.00 11. Medical Expense Deduction (see the worksheet in the instructions). . . . . . . . . . . . . . . . . . . . . 11. __________________________.00 12. Social Security Benefits Exempt from Taxation (see the worksheet in the instructions). . . . . . . . . . . . . . . . . . . . . 12. __________________________.00 13. Railroad Retirement income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. __________________________.00 14. Bond/note interest income from (see below). . . . . . . . . . . . . . . . 14. __________________________.00 15. Other (reserved) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. __________________________.00 16. Total Subtractions (ADD Lines 7 through 14). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. _ _________________________ .00 NET MODIFICATIONS TO FEDERAL ADJUSTED GROSS INCOME 17. SUBTRACT Line 16 from Line 6. Enter on Form IN-111, Line 2.. . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. _ _________________________ .00 This can be a negative number. Please PRINT in BLUE or BLACK INK Schedule IN-112 Page 1 of 2 Rev. 10/21 INCLUDE WITH FORM IN-111 Vermont Department of Taxes 2021 Schedule IN-112 Vermont Tax Adjustments and Credits

Taxpayer’s Last Name First Name MI Taxpayer’s Social Security Number VSAC Vermont Public Power Supply Authority Vermont Telecom Authority Build America *211121100* * 2 1 1 1 2 1 1 0 0 * RESERVED RESERVED 5454

PART II REFUNDABLE CREDITS Line 1 is for FULL-YEAR residents 1. Low Income Child & Dependent Care Credit . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. _________________.00

If your federal Adjusted Gross Income is $30,000 (or $40,000 for Married Filing Jointly) or less, and child care services are provided by a Vermont accredited daycare provider, enter 50% of federal Form 2441, Line 10. If you are not a Vermont resident or your daycare provider is not accredited, use Schedule IN-119, Part I, Line 8. See instructions if your providers are both accredited and not accredited. VERMONT EARNED INCOME TAX CREDIT For FULL-YEAR residents and PART-YEAR residents ELIGIBILITY QUESTIONS MUST BE ANSWERED A. Enter number of qualifying children. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A. _______________ B. Enter number of qualifying children under the age of 18. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. _______________ C. Were you (or your spouse if filing a joint return) at least age 18 at the end of 2021?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. If you answered “No” and do not have any qualifying children, you do not qualify for Earned Income Tax Credit FULL-YEAR RESIDENTS Answer eligibility questions above and complete Lines 2 and 3 2. Earned income tax credit (Reported on federal Form 1040). . . . . . . . . . . . . . . . . . . . . 2. __________________.00 3. Vermont Earned Income Tax Credit. MULTIPLY Line 2 by 36% (0.36). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. _______________ .00 PART YEAR RESIDENTS Answer eligibility questions above and complete Lines 4 through 10 4. Wages, salaries, tips, etc. (Schedule IN-113, Line 1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4A. _ ______________ .00 4B. _______________ .00 5. Other earned income (Schedule IN-113, Lines 8, 10, and 11) . . . . . . . . . . . . . . . . . . .5A. _ ______________ .00 5B. _______________ .00 6. Total earned income (Add Lines 4 and 5). . . . . . . . . . . . . . . . . 6A. _ ______________ .00 6B. _______________ .00 7. Earned income tax credit adjustment (DIVIDE Line 6B by Line 6A, MULTIPLY the result by 100, and enter here. Do not enter more than 100%.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7. __________ ._______% 8. Earned income tax credit (Reported on federal Form 1040). . . . . . . . . . . . . . . . . . . . . . . . . 8. _ ______________ .00 9. Multiply Line 8 by 36% and enter the result here. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9. _______________ .00 10. Vermont Earned Income Tax Credit (MULTIPLY Line 9 by Line 7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. _______________ .00 11. TOTAL REFUNDABLE CREDITS (ADD Line 1 to Line 3 or Line 10. Enter this amount on Form IN-111, Line 25c) . . . . . . . . . . . . . . . . . . . . . . . . . . 11. _______________ .00 Schedule IN-112 Page 2 of 2 Rev. 10/21 B. Vermont Portion $ For Vermont Portion, enter income earned while a Vermont resident as shown on Schedule IN-113, Column B, Lines 1, 8, 10, and 11 A. Federal Amount $ Enter figures in Column A from your federal EITC worksheet and Schedule IN-113 Yes No *211121200* * 2 1 1 1 2 1 2 0 0 *

Taxpayer’s Last Name Social Security Number 5454

Nonresidents and Part-Year Residents Must Complete Parts I and II Full-Year Residents with Adjustments Complete only Part II PART I. Enter figures as they appear on your federal return or recomputed federal return in Column A and list the Vermont portion in Column B. See instructions. A. Federal Amount $ B. Vermont Portion $ Schedule IN-113 Page 1 of 2 Rev. 10/21 Please PRINT in BLUE or BLACK INK INCLUDE WITH FORM IN-111 Vermont Department of Taxes 2021 Schedule IN-113 Vermont Income Adjustment Calculations

Dates of Vermont residency in 2021 From (MMDDYYYY): To (MMDDYYYY): Name of State(s), Canadian province, or country during non-Vermont residency (use standard 2-character abbreviation) / / / / *211131100* * 2 1 1 1 3 1 1 0 0 *

Taxpayer’s Last Name First Name MI Taxpayer’s Social Security Number

1. Wages, salaries, tips, etc. . . . . . . . . . . . . . . . . . . . 1A. ___________________________ .00 1B. __________________________.00

2. Taxable interest. . . . . . . . . . . . . . . . . . . . . . . . . . . 2A. ___________________________ .00 2B. __________________________.00

3. Ordinary dividends. . . . . . . . . . . . . . . . . . . . . . . . 3A. ___________________________ .00 3B. __________________________.00

4. Taxable IRAs, pensions, and annuities. . . . . . . . 4A. ___________________________ .00 4B. __________________________.00

5. Taxable Social Security. . . . . . . . . . . . . . . . . . . 5A. ___________________________ .00 5B. __________________________.00

6. Taxable refunds of state and local income taxes.6A. ___________________________ .00 6B. __________________________.00

7. Alimony received. . . . . . . . . . . . . . . . . . . . . . . . . 7A. ___________________________ .00 7B. __________________________.00

8. Business income or loss. . . . . . . . . . . . . . . . . . . . 8A. ___________________________ .00 8B. __________________________.00

9. Capital gain or loss . . . . . . . . . . . . . . . . . . . . . . . 9A. ___________________________ .00 9B. __________________________.00 10. Rents, royalties, partnerships, S corporations, trusts, etc. . . . . . . . . . . . . . . . . . 10A. ___________________________ .00 10B. __________________________.00 11. Farm income or loss . . . . . . . . . . . . . . . . . . . . . . 11A. ___________________________ .00 11B. __________________________.00 12. Unemployment compensation . . . . . . . . . . . . . . 12A. ___________________________ .00 12B. __________________________.00 13. Other: Specify. . . . . . . . . . . . . . . . . . . . . . . . . . . 13A. ___________________________ .00 13B. __________________________.00 14. TOTAL INCOME (ADD Lines 1 through 13). . . . . . . . . . . . . . . . 14A. ___________________________ .00 14B. __________________________.00 5454

Schedule IN-113 Page 2 of 2 Rev. 10/21 Column A. Federal Amount $ Column B. Vermont Portion $ *211131200* * 2 1 1 1 3 1 2 0 0 *

Taxpayer’s Last Name Social Security Number 15. IRA, Keogh/SEP/SIMPLE (Reported on federal Form 1040).. . . . . . . . . . 15A. ________________________ .00 15B. _ _________________________.00

Self _________________ Spouse _________________ 16. Student Loan Interest (Reported on Form 1040). . . . . . . . . . . . . . . . . 16A. ________________________ .00 16B. _______________________ .00 17. Employee Deductions: Reservists, Performing Artists, Fee-basis Gov’t Officials (Reported on Form 1040) . . . . . . . . . 17A. ________________________ .00 17B. _______________________ .00 18. Self-Employment Deductions: Tax and Health Insurance (Reported on Form 1040). . . 18A. ________________________ .00 18B. _______________________ .00 19. Health Savings Account (Reported on Form 1040). . . . . . . . . . . . . . . . . 19A. ________________________ .00 19B. _______________________ .00 20. Moving Expenses (Reported on Form 1040). . 20A. ________________________ .00 20B. _______________________ .00 21. Penalty on Early Withdrawal of Savings (Reported on Form 1040). . . . . . . . . . . . . . . . . 21A. ________________________ .00 21B. _______________________ .00 22. Alimony Paid (Reported on Form 1040). . . . . 22A. ________________________ .00 22B. _______________________ .00 23. Domestic Production Activities (Reported on Form 1040). . . . . . . . . . . . . . . . . 23A. ________________________ .00 23B. _______________________ .00 24. Educator Expenses and Tuition & Fees (Reported on Form 1040). . . . . . . . . . . . . . . . . 24A. ________________________ .00 24B. _______________________ .00 25. Deductions not listed above but reported on Form 1040. . . . . . . . . . . . . . . . . . . . . . . . . . 25A. ________________________ .00 25B. _______________________ .00 26. TOTAL ADJUSTMENTS (ADD Lines 15 through 25) . . . . . . . . . . . . . . 26A. ________________________ .00 26B. _______________________ .00 27. Adjusted Gross Income (SUBTRACT Line 26A from Line 14A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27. _______________________ .00 28. Vermont Portion of AGI (SUBTRACT Line 26B from Line 14B). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28. _______________________ .00 29. Non-Vermont Income (SUBTRACT Line 28 from Line 27) Also enter on Part II, Line 32 below. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29. _ _________________________.00 PART II. Adjustment for Vermont Exempt Income and Military Exempt Income 30. Adjusted Gross Income. If Part I completed, enter Line 27 amount. Otherwise, enter amount from Form IN-111, Line 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30. _______________________ .00 31a. Municipal Bond Interest. . . . . . . . . . . . . . . . . . . 31a. ________________________ .00 31b. ADD Lines 30 and 31a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31b. _______________________ .00 32. Non-Vermont Income (Line 29 above) . . . . . . . 32. ________________________ .00 33. Military pay. Number of months on active duty ______ (See instructions). . . . . . 33. ________________________ .00 34. Total (ADD Lines 32 and 33). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34. _______________________ .00 35. Vermont Income (SUBTRACT Line 34 from Line 30). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35. _______________________ .00 36. INCOME ADJUSTMENT % (DIVIDE Line 35 by Line 31b, MULTIPLY the result by 100 and carry the result out to the fourth decimal place.) Also enter on Form IN-111, Line 15 (See instructions). . . . . 36. _________ . __________% 5454

1. SPAN. To find your SPAN, please see instructions.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. _______________________________________ To determine eligibility, answer questions 2 through 4. 2. Were you domiciled in Vermont all of calendar year 2021? . . . . . . . 2. 3. Were you claimed as a dependent by another taxpayer in 2021? . . . 3. 4. Did you rent in Vermont for six months or more in 2021? . . . . . . . . 4. If you are eligible for a Renter Credit, complete Lines 5 through 9. 5. Did you share your rental unit with another adult who was not your jointly filed spouse?. . . . . . . . . . . . . . . . . . . . . . . 5. 6. Was your rent subsidized? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. 7. Number of months rented in 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. ____________________ 8. Number of Personal Exemptions claimed (from Form IN-111, Line 5d) (See the instructions if you did not file Form IN-111). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. ____________________ 9. Are you required to file a federal income tax return?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. If “Yes,” complete Lines 10 through 14. If “No” because your income was under the filing threshold, skip Lines 10 through 14, sign in the signature section, and submit the form. 10. Total Income (from federal Form 1040, Line 9). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. ________________ .00 11. 75% of nontaxable Social Security benefits (from federal Form 1040, Line 6a minus Line 6b. Multiply result by 0.75). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. ________________ .00 12. Tax-exempt interest (from federal Form 1040, Line 2a). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. ________________ .00 13. Add back any negative amounts from federal Form 1040, Line 7 and Schedule 1, Lines 3, 4, 5, 6, and 8a. (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. ________________ .00 14. Total (ADD Lines 10 through 13). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. ________________ .00 Form RCC-146 (Replaces Form PR-141) Page 1 of 1 Rev. 10/21 Vermont Department of Taxes 2021 Form RCC-146 Vermont Renter Credit Claim Yes, Go to Question 3. No, STOP. You are not eligible. Yes, STOP. You are not eligible. No, Go to Question 4. Yes, Go to Question 5. No, STOP. You are not eligible. *211461100* * 2 1 1 4 6 1 1 0 0 * For the year Jan 1 - Dec 31, 2021 Yes No Yes No

Claimant’s Last Name First Name MI Claimant’s Social Security Number

Spouse’s/CU Partner’s Last Name First Name MI Spouse’s or CU Partner’s Social Security Number

Mailing Address (Number and Street/Road or PO Box) Claimant’s Date of Birth (MM/DD/YYYY)

City State ZIP Code County of Rental Unit Vermont School District Code Physical Address of Rental Unit on 12/31/2021 Unit Number City/Town of Rental Unit on 12/31/2021 and State

Head of Household Married/CU Filing Separately Married/CU Filing Jointly Single Federal Filing Status Yes No / / Will you be using Renter Credit to pay Income Tax liability? Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Preparers cannot use return information for purposes other than preparing returns. Check if the Department of Taxes may discuss this return with the preparer shown. Signature

Date (MM/DD/YYYY) Daytime Telephone Number Signature (If a joint return, BOTH must sign.)

Date (MM/DD/YYYY) Daytime Telephone Number Paid Preparer’s Signature

Date (MM/DD/YYYY) Preparer’s Telephone Number Firm’s Name (or yours if self-employed) and address

Preparer’s SSN or PTIN FEIN - - Yes No

26 tax.vermont.gov FORM RCC-146 Renter Credit Claim - Line-by-Line Instructions Claimant Information Enter your name, your spouse/civil union partner’s name if filing a joint return, your Social Security Number(s), and your date of birth. Vermont School District Code If you do not know your Vermont School District Code for your rental, you can look it up in the Vermont income tax booklet table. Select the three-digit school district code for the town where you lived on Dec. 31, 2021, or the last rental unit for the year. Mailing Address Use the address where you receive mail from the United States Post Office. If the mailing address on your return is incorrect and the Department requires additional information, this will delay the processing of your return and your credit until we receive a valid mailing address. If you move after you submit your renter credit claim, please change your address with the Department as soon as possible. See our website to learn how to change your mailing address. Physical Address Enter your physical rental unit as of Dec. 31, 2021 or the last rental place you occupied. Your physical residence is where you lived and may be different from your mailing address. County Enter the county of the last rental unit you lived in during 2021. Federal Filing Status Enter the corresponding letter of the filing status used on your 2021 federal income tax return. If you are not required to file a federal income tax return, leave the box blank. Line 1 Enter the SPAN for the place you rented on December 31, 2021. If you do not know the number, you can look it up on our website at www.tax.vermont.gov. Lines 2 through 6 ALL questions must be answered or the claim cannot be processed. Check the appropriate “Yes” or “No” box for Lines 2 through 4 to determine your eligibility. Check the appropriate “Yes” or “No” box for Lines 5 and 6. Line 7 Indicate the total number of months you rented in 2021. Line 8 Enter the number of personal exemptions claimed on your Vermont Income Tax Return, Form IN-111, Line 5d. If you did not or are not required to file Form IN-111, complete the worksheet and enter the total on Line 8. Line 9 Check the appropriate “Yes” or “No” box if you filed a federal Form 1040. If your income does not require you to file because it was under the filing threshold, then you can skip Lines 10 through 14, sign the signature section, and submit the form. Line 10 Enter the Total Income from federal Form 1040, Line 9. If you did not file a federal Form 1040, see instructions above. Line 11 Seventy-five percent of nontaxable Social Security benefits from federal Form 1040, Line 6a minus Line 6b. Multiply result by 0.75. Line 12 Tax-exempt interest - Report the amount of tax-exempt interest reported on your federal Form 1040. Line 13 Loss add backs - Enter the amount of any negative amount (net loss) shown on federal Form 1040 or Form 1040-SR, Line 7, and federal Schedule 1, Lines 3, 4, 5, 6, and 8a. Enter the total of the amounts as a positive number. Loss would include business loss, capital loss, net operating losses including carryforward NOL, trust and estate loss, sale of business personal property loss and farm losses. Line 14 Add Lines 10 through 13. Enter total here. Signature Sign and date the claim. An unsigned claim is considered incomplete and UNFILED. Disclosure Authorization If you wish to give the Department authorization to discuss your 2021 Renter Credit Claim with your tax preparer, check this box and include the preparer’s name. This authorization will automatically end April 18, 2027. Preparer If you are a paid preparer, you must also sign the claim, enter your Social Security Number or PTIN and, if employed by a business, the FEIN of the business.

If someone other than the filer(s) prepared the return without charging a fee, then that preparer’s signature is optional. See page 34 for Form RCC-146, General Instructions PERSONAL EXEMPTIONS WORKSHEET Complete this worksheet if you did not file a federal Form 1040 and Vermont Income Tax Return, Form IN-111 1. Enter “1” for yourself if no one can claim you as a dependent. . . . . . . . . . . . . . . . . . . . . . 1. _____ 2. Enter “1” for your jointly filed spouse or CU partner if no one can claim them as a dependent or if you are a qualifying widow(er). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. _____ 3. Enter number of other dependents claimed on federal Form 1040. This includes any dependents other than yourself and/or your spouse, that no one else has claimed . . . . . . . . 3. _____ 4. Add Lines 1 through 3. . . . . . . . . . . . . . . . . . 4. _____ NOTE: A dependent is someone that resided with you for at least 183 days or more in 2021, qualifies as your dependent under federal rules and didn’t provide over half of their own support in 2021.

Claimant’s Last Name First Name MI Claimant’s Social Security Number

Spouse’s/CU Partner’s Last Name First Name MI Spouse’s or CU Partner’s Social Security Number

Mailing Address (Number and Street/Road or PO Box) Claimant’s Date of Birth (MM/DD/YYYY)

City State ZIP Code

Location of Homestead (Use a number, street/road name. Do not use a PO Box or “same.”) City/Town of Legal Residence on April 1, 2022 and State

Head of Household Married/CU Filing Separately Married/CU Filing Jointly Single Federal Filing Status A1. SPAN - REQUIRED (from the 2021/2022 property tax bill). . . . . . . . . . . . . . . . . . . . . . . . . A1. _______________________________________ A2. Business Use of Dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A2. ___________ .______ % A3. Rental Use of Dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A3. ___________ .______ % A4. Business or Rental Use of Improvements or Other Buildings Not including the dwelling, are improvements or other buildings located on your parcel used for business or rented?. . . . A4. A5-A8 Special Situations (See instructions for more information). Check the following if it applies: DUE DATE: April 18, 2022. You may file up to Oct. 17, 2022, but the town may assess a penalty. For details on late filing, see the instructions. How to file a Homestead Declaration: Please complete Section A of this form, sign in the signature section at the bottom of page 2, and send the form to the Vermont Department of Taxes How to file a Property Tax Credit Claim: To be considered for a Property Tax Credit, you must file a 1) Homestead Declaration (Section A of this form), 2) Property Tax Credit Claim (Section B of this form), and 3) Schedule HI-144, Household Income. Sign this form in the signature section at the bottom of page 2 and send the forms to the Department. Tired of paper forms? It’s fast and convenient to file your claim online at myVTax.vermont.gov. Please PRINT in BLUE or BLACK INK Form HS-122 Page 1 of 2 Rev. 10/21 Annual Vermont Homestead Declaration This form must be filed each year by every Vermont resident whose property meets the definition of a homestead. A Vermont homestead is the principal dwelling and parcel of land surrounding the dwelling, owned and occupied by a resident individual as the individual’s domicile on April 1, 2022. If your homestead is leased to a tenant on April 1, 2022, you may still claim it as a homestead if it is not leased for more than 182 days in the 2021 calendar year. SECTION A. Yes No Vermont Department of Taxes 2022 Form HS-122 Vermont Homestead Declaration AND Property Tax Credit Claim Residing in a dwelling on the homestead parcel owned by a related farmer. A8. Homestead property crosses town boundaries (File a declaration for each town.) A7. Grantor and sole beneficiary of a revocable trust owning the property A5. Life estate holder of the property A6. Please continue to Page 2, Part B, for property tax credit. Sign on Page 2. Mail to: Vermont Department of Taxes

PO Box 1881

Montpelier, VT 05601-1881 / / *221221100* * 2 2 1 2 2 1 1 0 0 * - - 5454

DUE DATE: April 18, 2022. Claims accepted up to Oct. 17, 2022. PROPERTY TAX CREDIT CLAIM For Household Income up to $136,900. Complete and attach Schedule HI-144. SECTION B. To qualify, you must meet the requirements for filing a homestead declaration in addition to the following requirements. ALL eligibility questions must be answered. Form HS-122 Page 2 of 2 Rev. 10/21 Yes, Go to Line B2. No, STOP. Yes, STOP. No, Go to Line B3. Yes, STOP. No, Continue Check here if amended Schedule HI-144, Household Income, is included. MAXIMUM CREDIT AMOUNT IS $8,000. Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Preparers cannot use return information for purposes other than preparing returns. Signature

Date (MMDDYYYY) Daytime Telephone Number Signature (If a joint return, BOTH must sign.)

Date (MMDDYYYY) Daytime Telephone Number Paid Preparer’s Signature

Date (MMDDYYYY) Preparer’s Telephone Number Firm’s Name (or yours if self-employed) and address

Preparer’s SSN or PTIN FEIN *221221200* * 2 2 1 2 2 1 2 0 0 *

Claimant’s Last Name Social Security Number B1. Were you domiciled in Vermont all of calendar year 2021? . . . . . . . . B2. Were you claimed as a dependent in 2021 by another taxpayer?. . . . . B3. Do you anticipate selling this Vermont housesite on or before April 1, 2022? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Amounts for Lines B4-B6 are found on the 2021/2022 property tax bill. Round amounts to the nearest dollar. B4. Housesite Value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B4. __________________________.00 B5. Housesite Education Tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B5. __________________________.00 B6. Housesite Municipal Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B6. __________________________.00 B7. Ownership Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .B7. ___________ .______ % B8. Household Income (Schedule HI-144, Line z). You MUST attach Schedule HI-144. . . . . . . . . . . . . . . . . . . . . . . . . . . . . B8. ______________________.00 Complete the following ONLY if applicable. See instructions for details. B9. Lot Rent (Allocable Rent from Form LRC-147) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B9. __________________________.00 Allocated Property Tax from Land Trust, Cooperative, or Nonprofit Mobile Home Park B10. Allocated Education Tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B10. __________________________.00 B11. Allocated Municipal Tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B11. __________________________.00 OR Property Tax from contiguous property if housesite has less than 2 acres (See instructions.) B12. Contiguous property Education Tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B12. __________________________.00 B13. Contiguous property Municipal Tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B13. __________________________.00 Check if the Department of Taxes may discuss this return with the preparer shown. 5454

Please PRINT in BLUE or BLACK INK This schedule must be included with the 2022 Property Tax Credit Claim (Form HS-122). Please read instructions before completing schedule. List the names and Social Security Numbers of all other persons (in addition to a Spouse or CU Partner) who had income and lived with you during 2021. Include both their taxable and non-taxable income in Column 3. If you have more than two “Other Persons” living in your household, record the names and Social Security Numbers on a separate sheet of paper and include with the filing. Yearly totals of ALL members of the household 1. Claimant /Claimant and jointly filed Spouse 2. Filing separately Spouse or CU Partner 3. Other Persons Schedule HI-144 Page 1 of 2 Rev. 10/21 a. Cash public assistance and relief (See instructions for exclusions) . . . . a._____________.00 _____________.00 ____________ .00 b. Social Security, SSI, disability, railroad retirement, veteran’s benefits, taxable and nontaxable. . . . . . . . . . . . . . . . . . . . . . . b._____________.00 _____________.00 ____________ .00 c. Unemployment compensation/worker’s compensation. . . . . . . . . . . . . . c._____________.00 _____________.00 ____________ .00 d. Wages, salaries, tips, etc. (See instructions for dependent’s exempt income.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d._____________.00 _____________.00 ____________ .00 e. Interest and dividends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e._____________.00 _____________.00 ____________ .00 f. Interest on U.S., state, and municipal obligations, taxable and nontaxable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .f._____________.00 _____________.00 ____________ .00 g. Alimony and support money. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . g._____________.00 _____________.00 ____________ .00 h. Child support and cash gifts Please specify__________________________ . . . . . . . . . . . . . . . . . . . h._____________.00 _____________.00 ____________ .00 i. Business income. If the amount is a loss, enter -0-. See instructions for offsetting a loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . .i._____________.00 _____________.00 ____________ .00 j. Capital gains, taxable and nontaxable. If the amount is a loss, enter -0-. See instructions for offsetting a loss . . . . . . . . . . . . . . . . . . . j._____________.00 _____________.00 ____________ .00 k. Taxable pensions, annuities, IRA and other retirement fund and distributions. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . k._____________.00 _____________.00 ____________ .00 l. Rental and royalty income. If the amount is a loss, enter -0-. See instructions for offsetting a loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . .l._____________.00 _____________.00 ____________ .00 m. Farm/partnerships/S corporations/LLC/Estate or Trust income. If the amount is a loss, enter -0-. See Line m instructions for only exception to offset a loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .m._____________.00 _____________.00 ____________ .00 n. Other income (See instructions for examples of other income) Please specify__________________________ . . . . . . . . . . . . . . . . . . . n._____________.00 _____________.00 ____________ .00 o. Total Income: ADD Lines a through n. . . . . . . . . . . . . . . . . . . . . . . o.______________.00 ______________ .00 _ _____________.00

Claimant’s Last Name First Name MI Claimant’s Social Security Number

Spouse’s/CU Partner’s Last Name First Name MI Claimant’s Date of Birth (MMDDYYYY) Vermont Department of Taxes 2021 Schedule HI-144 Household Income For the year Jan 1 - Dec 31, 2021

Other Person #1 Last Name First Name MI Other Person #1 Social Security Number

Other Person #2 Last Name First Name MI Other Person #2 Social Security Number *211441100* * 2 1 1 4 4 1 1 0 0 * 5454

p. See instructions. Enter Social Security and Medicare tax withheld on wages claimed on Line d. Self-Employed: Enter self-employment tax from Federal Schedule SE. This entry may differ from W-2/1099 or Federal Schedule SE amount if these taxes are paid on income not required to be reported on Schedule HI-144. Include W-2 and/or Federal Schedule SE if not included with income tax filing. . . . . . p.____________.00 _____________.00 _____________.00 q. Child support paid. You must include proof of payment. See instructions. . . . . . . . q._____________ .00 ______________.00 ______________ .00 r. Allowable adjustments from Federal Form 1040 r1. Business expenses for Reservists . . . . r1. ____________.00 _____________.00 _____________.00 r2. Alimony paid . . . . . . . . . . . . . . . . . . . r2. ____________.00 _____________.00 _____________.00 r3. Self-employed health

insurance deduction. . . . . . . . . . . . . . . r3. ____________.00 _____________.00 _____________.00 r4. Health Savings Account deduction. . . r4. ____________.00 _____________.00 _____________.00 r5. Tuition and Fees as reported on

federal Form 8917. . . . . . . . . . . . . . . . r5. ____________.00 _____________.00 _____________.00 s. ADD Lines p, q, and total of Lines r1 through r5 for each column. . . . . s. ____________.00 _____________.00 _____________.00 t. SUBTRACT Line s from Line o of each column. If a negative amount, enter -0- .. . . t. ____________.00 _____________.00 _____________.00 u. ADD all three amounts from Line t. If a negative amount, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u.____________ .00 v. Complete if born Jan. 1, 1957 and after. Enter interest and dividend income from Lines e and f.. . . . . . . . . . . . . . . . . . . . . . . . . v. ____________.00 _____________.00 _____________.00 w. ADD all three amounts from Line v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . w.____________ .00 x. Asset Adjustment of Interest and Dividend Income (Lines e and f). Per 32 V.S.A. § 6061E. . . . . . . . . . . . . . . . . . . . . . . . . x. ________________ y. SUBTRACT Line x from Line w. If Line x is more than Line w, enter -0- .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . y.____________ .00 z. HOUSEHOLD INCOME. ADD Line u and Line y. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . z.____________ .00 HOMEOWNERS Form HS-122, Homestead Declaration AND Property Tax Credit Claim, must be filed each year.

Homeowners with Household Income up to 136,900 on Line z should complete Form HS-122, Section B. You may be eligible for a property tax credit. This schedule must be filed with Form HS-122.

Form HS-122 The due date to file is April 18, 2022. Homeowners filing a property tax credit, Form HS-122 and Schedule HI-144, between April 19 and Oct. 17, 2022, may still qualify for a Property Tax Credit. A $15 late filing fee will be deducted from the credit. Schedule HI-144 Page 2 of 2 Rev. 10/21

Support paid to: Last Name First Name MI Social Security Number 10,000.00 1. Claimant /Claimant and jointly filed Spouse 2. Filing separately Spouse or CU Partner 3. Other Persons

Carried forward from Line o. . . . . . . _____________ .00 ______________.00 ______________ .00 *211441200* * 2 1 1 4 4 1 2 0 0 *

Claimant’s Last Name Social Security Number 5454

31 tax.vermont.gov Line 4 Federal Bonus Depreciation. Vermont does not recognize the bonus depreciation allowed under federal law. Enter the difference between the depreciation calculated by standard MACRS methods and the depreciation calculated using the federal bonus depreciation for assets placed in service in 2021. Read Technical Bulletin TB-44, Disallowance of Bonus Depreciation Provisions of Federal Economic Stimulus Act of 2008, on our website for information on calculating the amount to add back to taxable income. Line 5 Reserved Line 6 Total Federal Adjusted Gross Income Additions. Add Lines 3 and 4. Subtractions From Federal Adjusted Gross Income Line 7 Interest Income from U.S. Obligations. Interest income from U.S. government obligations (such as U.S. Treasury bonds, bills, and notes) is exempt from Vermont tax under the laws of the United States. Enter the amount of interest income from U.S. Obligations on this line. Read Technical Bulletin TB-24, Exemption of Income of U.S. Government Obligations, on our website. Line 8 Capital Gains Exclusion. See Schedule IN-153, Capital Gains Exclusion Calculation, and instructions to calculate the capital gains exclusion for 2021. Read Department regulation § 1.5811(21)(B)(ii) and Technical Bulletin TB-60, Taxation of Gain on the Sale of Capital Assets, on our website to help determine your capital gain exclusion. Complete and submit Schedule IN-153. Line 9 Adjustment for Bonus Depreciation on Prior Year Property. Enter the difference between the depreciation calculated by standard MACRS methods and the depreciation calculated at the federal level. For information on calculating the amount that can be subtracted from taxable income, read Technical Bulletin TB-44 on our website. Line 10 Taxable Refunds of State and Local Income Taxes. Enter the amount reported on your federal Form 1040. Line 11 Medical Expenses Deduction. Complete the worksheet located in the instructions. Line 12 Social Security Benefits Exempt from Vermont Taxation. Complete the worksheet located in the instructions. Line 13 Enter the amount you received in 2021 for Regular Railroad Retirement Benefits (Tier 1) and Supplemental Railroad Annuity Payments (Tier 2). This income is taxable at the federal level, but exempt from Vermont income tax. If you receive Social Security that includes Tier 1 or Tier 2 benefits, enter only the portion included in your federal Adjusted Gross Income. You may be asked to provide the Required Supporting Documents: Copies of 1099, 1099RB, WP-4, or any other document you received showing payment of these benefits. Line 14 The interest or income from a bond or note of: 1) Vermont Student Assistance Corporation, 2) Build America, 3) Vermont Telecommunications Authority, or 4) Vermont Public Power Supply Authority is exempt from Vermont income tax to the extent the interest or income is included in federal Adjusted Gross Income. Enter the amount of interest or income from these sources that is also included in your federal Adjusted Gross Income. Line 15 Reserved Line 16 Total Federal Adjusted Gross Income Subtractions. Add Lines 7 through 14. Line 17 Net Modifications to Federal Adjusted Gross Income. Subtract Line 16 from Line 6. If Line 6 is less than Line 16, use a hyphen (“-”) to indicate a negative. Enter on Form IN-111, Vermont Income Tax Return, Line 2. Part II Refundable Credits Line 1 Low Income Child & Dependent Care Credit (Vermont Residents only)

If care expenses are from both accredited and non- accredited providers, complete the worksheet to calculate the credit.

Eligible taxpayers receive 50% of the federal Child and Dependent Care Credit as a refundable Vermont income tax credit instead of the nonrefundable 24% credit from Schedule IN-119, Vermont Tax Adjustments and Nonrefundable Credits.

Taxpayers must meet the following requirements: • Your income must be either: - less than $30,000 federal Adjusted Gross Income for taxpayers filing as Single, Head of Household, Married Filing Separately, Civil Union Filing Separately

OR - less than $40,000 federal Adjusted Gross Income for taxpayers filing as Married Filing Jointly, Civil Union Filing Jointly, Qualifying Widow(er) Continued from page 15 1. Accredited care provider amount. . . . . . 1.________________________

2. Total care amount. . . . . . . . . . . . . . . . . . 2.________________________

3. Divide Line 1 by Line 2. . . . . . . . . . . . . . 3.________________________ $___________ x __________ = $___________ x 50% = $ ____________ Federal Credit Line 3 above Eligible Credit Low Income Credit (Form 2441,

IN-112, Part II,

Line 10)

Line 1 You may wish to also calculate your VT tax credit using 24% of the full Federal credit and compare to the credit calculated on this worksheet to determine which credit is best for you. NOTE: You cannot take both credits. LOW INCOME CHILD & DEPENDENT CARE WORKSHEET

32 tax.vermont.gov • Care in 2021 must be provided by a home or facility located in Vermont accredited by the Vermont Agency of Human Services. Include a copy of your federal Form 2441, Child and Dependent Care Expenses. To determine if your care provider is accredited, go to our website or call the Department of Children and Families at (800) 649-2642. Vermont Earned Income Tax Credit (for Full-Year and Part-Year Vermont Residents Only)

In order to qualify for the Vermont Earned Income Tax Credit, a taxpayer must first be eligible for a federal Earned Income Tax Credit.

Supporting Documents Required: Evidence of earned income such as W-2 or self-employment schedule(s).

Eligibility questions A, B, and C must be answered. The claim will be disallowed if the questions are not answered. Full-Year Residents Line 2 Enter the amount of your federal Earned Income Tax Credit. Line 3 Multiply Line 2 by 36% (0.36). Enter the result. Part-Year Residents Line 4A Enter the federal amount of wages, salaries, tips, etc. Line 4B Enter the portion of federal wages, salaries, tips, etc. earned while a Vermont resident. Lines 5A & 5B Other earned income includes income from a business, partnership, or farm. Line 6A In Column A, add Lines 4 and 5 and enter the result. Line 6B In Column B, add Lines 4 and 5 and enter the result. Line 7 Divide Line 6A by Line 6B. Enter the result as a percentage carried out to two decimal places but not greater than 100%. This is the percentage of 2021 income earned in Vermont that is eligible for the Vermont Earned Income Tax Credit. Line 8 Enter the amount of your federal Earned Income Tax Credit. Line 9 Multiply Line 8 by 36% (0.36) and enter result. Line 10 Multiply Line 9 by Line 7. Enter the result. Line 11 TOTAL REFUNDABLE CREDITS

Add Line 1 to Line 3 or Line 10. Enter this amount on Form IN-111, Line 25c. SCHEDULE IN-113 Income Adjustment WHO MUST FILE IN-113

You must file Schedule IN-113 if you are either: • a nonresident or part-year resident and earned or received Vermont income, OR • a Vermont resident claiming income exempt from Vermont income tax Nonresident: Complete both Parts I and II to determine the allocation of Vermont income. Visit our website for definition of nonresident income. Resident: Complete Part II to adjust for Vermont tax exempt military pay and municipal bond interest. Part-Year Resident: Part-year residents may, in some cases, be able to adjust Vermont income by both the Vermont percentage of income on Schedule IN-113 and claim a credit for income tax paid to another tax jurisdiction on Schedule IN-117, Vermont Credit for Income Tax Paid to Other State or Canadian Province. The income tax paid to the other tax jurisdiction must be for income earned while a Vermont resident. Schedule IN-117, Line 2 cannot exceed the amount on Schedule IN-113, Line 27. Visit our website for more information. Dates of Vermont Residency in 2021 Enter the dates you lived in Vermont in 2021. Leave blank if you did not live in Vermont. Name of State(s) During Non-Vermont Residency Write the names of the other states, Canadian provinces, or countries where you were a resident in 2021 using standard 2-letter abbreviations. PART I (For Nonresidents and Some Part-Year Vermont Residents)

Unless otherwise indicated in the line instructions, the Vermont portion is the income received from Vermont sources or received while a Vermont resident. Lines 1 - 13, Column A Enter the income for these categories as shown on your federal income tax return. NOTE: For Line 3A - Use taxable amount “Ordinary dividends” from federal Form 1040, U.S. Individual Income Tax Return.

33 tax.vermont.gov For Line 10A - Use amount from federal Schedule K-1 (Form 1065), Partner’s Share of Income, Deductions, Credits, etc., before recalculation for exclusion of bonus depreciation. For Line 12A - Use amount reported on federal Form 1040, Schedule 1. For Line 13A - Use amounts from federal Form 1040, Schedule 1, lines reporting “other gains and losses” and “other income.” Line 13, Column A Examples of other income: gambling winnings including lotteries, raffles, or lump-sum payment from sale of right to receive future lottery annuity; reimbursement this year for items itemized last year such as medical expenses; interest; income from rental of personal property; taxable distributions from Coverdell Education Savings Account or Qualified Tuition Plan, medical savings account or Archer Medical Savings Account. Lines 1 - 13, Column B Enter the Vermont portion for these categories from your federal income tax return.

NOTE: For Line 3B - Use the amount of ordinary dividends received while a Vermont resident. For Line 9B - Include amount from Line 2 of Vermont Schedule K-1VT, Shareholder, Partner, or Member Information plus all additional Vermont-sourced capital gains. For Line 10B - Use sum of Line 1 and Line 3 of Schedule K-1VT before recalculation for exclusion of bonus depreciation. For Line 12B - Enter total amount received for Vermont unemployment. For Line 13B - Use the amount of other income earned or received from federal Form 1040, Schedule 1, lines reporting “other gains and losses” and “other income,” from Vermont sources. Lines 15 - 23, Column A Enter the amount for these categories as shown on your federal Form 1040. Lines 15 - 23, Column B Enter the portion of the deductions paid or incurred during your Vermont residency or resulting from Vermont income earned or received. Line 24, Column A Enter the combined amounts of Educator Expenses and Tuition and Fees from federal Form 1040. Line 24, Column B The Vermont portion of Educator Expenses and Tuition and Fees during Vermont residency. Line 25, Column A Enter deduction(s) to Adjusted Gross Income that are included in the total on federal Form 1040. Line 25, Column B Enter the portion of the deductions paid or incurred during your Vermont residency or resulting from Vermont income earned or received. PART II Adjustment for Vermont Exempt Income Line 30 If Part I is completed, enter the amount from Line 27. Otherwise, enter Adjusted Gross Income from Form IN-111, Line 1. Line 31a Enter the amount of income from Non-Vermont State and Local Obligations reported on Vermont Schedule IN-112, Line 3. Line 31b Add Lines 30 and 31a and enter total on Line 31b. Line 32 Part-Year Residents and Nonresidents: Enter the amount from Part I, Line 29. Full-Year Residents: Enter -0-. Line 33 Enter the amount of Vermont exempt military pay received in 2021 that is included in your federal Adjusted Gross Income. Exempt military pay is: I. Wages earned from the armed services for full-time active duty outside of Vermont. You may be asked to provide the Required Supporting Documents: Copy of active duty orders. II. Up to $2,000 for National Guard or U.S. Reserve training pay earned in Vermont if your Adjusted Gross Income for tax year 2021 is less than $50,000. You may be asked to provide the Required Supporting Documents: Copy of DFAS form or certification statement from your unit that all training was completed during the calendar year. III. Student loan repayment can be taken only if the amount is included in your Adjusted Gross Income. Enter the repayment benefit made under 10 U.S.C. Chapters 109 and 1609 for 2021. You may be asked to provide the Required Supporting Documents: Certification statement from armed services showing your name, address, Social Security Number, amount of student loan repayment, and payment date. Line 34 Add Lines 32 and 33 and enter result. This is the total amount of income not subject to Vermont income tax. No entry is needed on this line if you did not have entries on Lines 32 and 33. Line 35 Subtract Line 34 from Line 30. This is the Vermont income subject to tax. Line 36 Divide Line 35 by Line 31b. Also enter on Form IN-111, Line 15.

Carry out to four decimal places. Example: XX.XXXX%

Dealing with negatives: • If Line 30 is a negative and Line 34 is a positive, enter 100% • If Line 34 is a negative, enter 0% • If Lines 30 and 34 are negative, enter 0%

34 tax.vermont.gov FORM RCC-146 Renter Credit Claim General Instructions The Vermont legislature made substantial changes to the Renter Credit program in Act 160 of 2020. These changes will impact claims filed during the 2022 income tax filing season for rental activity that occurred during the 2021 calendar year. The Renter Credit Program refunds eligible renters a portion of their rent paid based on HUD fair market rent guidelines. Eligibility for Renter Credit: You must meet all the following eligibility requirements: 1. You were domiciled in Vermont for the entire calendar year 2021 2. You were not claimed in 2021 as a dependent of another taxpayer 3. You rented in Vermont for at least 6 months in 2021

You are no longer required to obtain a landlord certificate from your landlord in order to apply for a Renter Credit. However, your landlord is required to file a certificate with the Department in order for your application to be honored. You will need to know the SPAN for the unit you are filing on. Missing Information or Incomplete Filing: Claims that are incomplete or are missing key information will be considered UNFILED. Deceased Renter: A claim cannot be filed on behalf of a deceased person. The right to file a Renter Credit Claim is personal to the claimant and does not survive the claimant’s death, regardless if they had rented the entire calendar year. Lot Rent: Do NOT file a renter credit if the rent you pay is for lot rent for your mobile home. See instructions for Form HS-122, Homestead Declaration and Property Tax Credit Claim. E-file your Renter Rebate for quicker processing at myVTax.vermont.gov. Due Date: Your application must be filed no later than the Oct. 17 filing deadline. Returns received after this date cannot be accepted. Injured Spouse Claims: To make an “injured spouse” claim, send the following information prior to filing your claim: 1. copy of federal Form 8379, Injured Spouse Allocation (if you filed one with the IRS) 2. your signed letter of request 3. a copy of your current lease

Mail to: ATTN: Injured Spouse Unit, Vermont Department of Taxes, PO Box 1645, Montpelier, VT 05601-1645.

The Department will notify you if the renter credit is taken to pay a bill. You have 30 days from the date on the notice to submit the injured spouse claim to the Department. See page 26 for Form RCC-146, Line-by-Line Instructions 2021 Partial Credit Income Limits by County

FAMILY SIZE

COUNTY 1 2 3 4 5 6 7 8

ADDISON $29,300 $33,500 $37,700 $41,850 $45,200 $48,550 $51,900 $55,250

BENNINGTON $27,450 $31,350 $35,250 $39,150 $42,300 $45,450 $48,550 $51,700

CALEDONIA $27,450 $31,350 $35,250 $39,150 $42,300 $45,450 $48,550 $51,700

CHITTENDEN $33,600 $38,400 $43,200 $47,950 $51,800 $55,650 $59,500 $63,300

ESSEX $27,450 $31,350 $35,250 $39,150 $42,300 $45,450 $48,550 $51,700

FRANKLIN $28,240 $32,260 $36,280 $40,290 $43,530 $46,770 $49,980 $53,210

GRAND ISLE $28,240 $32,260 $36,280 $40,290 $43,530 $46,770 $49,980 $53,210

LAMOILLE $27,450 $31,350 $35,250 $39,150 $42,300 $45,450 $48,550 $51,700

ORANGE $27,450 $31,350 $35,250 $39,150 $42,300 $45,450 $48,550 $51,700

ORLEANS $27,450 $31,350 $35,250 $39,150 $42,300 $45,450 $48,550 $51,700

RUTLAND $27,450 $31,350 $35,250 $39,150 $42,300 $45,450 $48,550 $51,700

WASHINGTON $28,800 $32,900 $37,000 $41,100 $44,400 $47,700 $51,000 $54,300

WINDHAM $27,450 $31,350 $35,250 $39,150 $42,300 $45,450 $48,550 $51,700

WINDSOR $27,600 $31,550 $35,500 $39,400 $42,600 $45,750 $48,900 $52,050 2021 Full Credit Income Limits by County

FAMILY SIZE

COUNTY 1 2 3 4 5 6 7 8

ADDISON $17,600 $20,100 $22,600 $26,500 $31,040 $35,580 $40,120 $44,660

BENNINGTON $16,450 $18,800 $21,960 $26,500 $31,040 $35,580 $40,120 $44,660

CALEDONIA $16,450 $18,800 $21,960 $26,500 $31,040 $35,580 $40,120 $44,660

CHITTENDEN $20,150 $23,000 $25,900 $28,750 $31,050 $35,580 $40,120 $44,660

ESSEX $16,450 $18,800 $21,960 $26,500 $31,040 $35,580 $40,120 $44,660

FRANKLIN $16,940 $19,350 $22,360 $26,690 $31,040 $35,580 $40,120 $44,660

GRAND ISLE $16,940 $19,350 $22,360 $26,690 $31,040 $35,580 $40,120 $44,660

LAMOILLE $16,450 $18,800 $21,960 $26,500 $31,040 $35,580 $40,120 $44,660

ORANGE $16,450 $18,800 $21,960 $26,500 $31,040 $35,580 $40,120 $44,660

ORLEANS $16,450 $18,800 $21,960 $26,500 $31,040 $35,580 $40,120 $44,660

RUTLAND $16,450 $18,800 $21,960 $26,500 $31,040 $35,580 $40,120 $44,660

WASHINGTON $17,300 $19,750 $22,200 $26,500 $31,040 $35,580 $41,120 $44,660

WINDHAM $16,450 $18,800 $21,960 $26,500 $31,040 $35,580 $40,120 $44,660

WINDSOR $16,600 $18,950 $21,960 $26,500 $31,040 $35,580 $40,120 $44,660

35 tax.vermont.gov Homestead Declaration and Property Tax Credit FORM HS-122 SECTION A Vermont Homestead Declaration THE HOMESTEAD DECLARATION must be filed each year by Vermont residents for purposes of the state education tax rate. The Declaration identifies the property as the homestead of the Vermont resident. A Vermont homestead is taxed at the homestead education property tax rate, while a different education property tax rate applies to nonhomestead property (previously known as the “nonresidential” rate). Nonhomestead property is property used for commercial purposes or property not used as the principal (primary) residence, such as a second home, camp, or summer cottage. A property may be classified as both homestead and nonhomestead. This occurs when a part of the home is used for commercial purposes or as a rental. The property tax bill will show a homestead education property tax rate and a nonhomestead education property tax rate. For more information on the Homestead Declaration, please visit our website tax.vermont.gov for our quick reference guides and statutes. You must file a declaration by April 18, 2022, if you meet all of the following eligibility requirements: 1. Own the Vermont property as your principal residence as of April 1, 2022, AND 2. Expect to physically occupy the Vermont property as your domicile. The declaration must be filed even if it is late. NOTE: If you meet these requirements, except that your homestead is leased to a tenant on April 1, 2022, you may still claim it as a homestead if it is not leased for more than 182 days in the calendar year. Other ownership circumstances include the following: • When there is more than one owner (joint ownership), only one owner occupant should file. • Owners with a life estate interest who occupy the dwelling as their principal residence must file. • Certain trusts may qualify as a homestead. For more information, read Reg. § 1.5401(7) Homestead on our website. Please note that changes to this regulation are being proposed to conform to amendments made to this statute. • An estate holding a residence that was the homestead of the deceased person at the time of death may file a homestead if the residence is not rented. • When the residence is owned by the estate of the deceased spouse, the widow or widower may file a homestead declaration as long as it is likely that the residence will pass to the widow or widower when the estate is settled. Homestead Declarations filed by April 18, 2022, are considered timely, classified as homesteads on the grand list, and taxed at the homestead education property tax rate. Homestead Declarations filed after April 18, 2022, are classified as homesteads but may be assessed the following penalty by the town: • Up to 3% if the nonhomestead rate is higher than the homestead education property tax rate. • Up to 8% if the nonhomestead rate is lower than the homestead education property tax rate. Homestead Declarations filed after Oct. 17, 2022, will be classified as nonhomestead. The owner will be charged the higher of the two rates, assessed a penalty, and must pay any additional property tax and interest due. What if you SELL your property before April 1, 2022? If you filed a Homestead Declaration and Property Tax Credit Claim before April 1, 2022, you must withdraw the declaration and claim using Form HS-122W, available on our website. What if you rent your homestead on April 1 and occupy it yourself for fewer than 183 days in the calendar year? You must withdraw the declaration using Form HS-122W, Vermont Homestead Declaration and/or Property Tax Credit Withdrawal. Form HS-122W is available on our website. If you occupy your home fewer than 183 days, you are disqualified from filing both the Homestead Declaration and the Property Tax Credit Claim. Claimant Information: Enter your Social Security Number, name, and mailing address. If applicable, enter the Social Security Number and name of your spouse/civil union partner. Enter your date of birth. Example: March 27, 1948, is entered as 03 27 1948 Location of Homestead: Enter the physical location (street, road name) Please do not enter a post office box or write “same,” “see above,” or the city/town name. Examples: 123 Maple Street or 276 Route 12A Legal Residence: Enter the town or city name of your legal residence as of April 1, 2022. If there is both a city and town with the same name, please specify. Examples: Barre City or Barre Town, St. Albans City or St. Albans Town Federal Filing Status: Check the box to indicate the filing status used on your 2021 federal income tax return. If you are not required to file a federal income tax return, leave the box blank. Line A1 SPAN (School Property Account Number): This is a unique 11-digit identification number assigned by the town or city and is printed on the property tax bill. It is very important to verify your SPAN. The property tax credit is credited to the property tax bill for this SPAN.

36 tax.vermont.gov Line A2 Business Use of Dwelling: Enter percentage of the dwelling used for business. Leave blank if there is no business use or the business use is 25% or less. Line A3 Rental Use of Dwelling: Enter the percentage of the dwelling that is rented. All rental use is required to be reported even if it is 25% or under. Line A4 Business or Rental Use of Improvements and Other Buildings on the Property Check the applicable “Yes” or “No” box. Check the “Yes” box if any improvements or other buildings are rented out or used for business. Lines A5-A8 Special Situations: Check situation applicable. FORM HS-122 SECTION B Property Tax Credit Claim To be eligible for a Property Tax Credit, you must meet all of the following eligibility requirements: 1. The property must be declared as your homestead. 2. You were domiciled in Vermont for the entire 2021 calendar year. 3. You own the property as your principal residence on April 1, 2022. 4. You were not claimed as a dependent of another taxpayer for the 2021 tax year. 5. You meet the household income criteria of $136,900 or less. Due Date - April 18, 2022

Claims for Property Tax Credits filed between April 18 and Oct. 17, 2022, will have a $15 late filing fee deducted from the property tax credit. 2022 Property Tax Credits filed after Oct. 17, 2022, cannot be accepted. Incomplete claims cannot be processed and are considered unfiled. Receipt Date Forms mailed through the U.S. Post Office are considered timely if received by the Vermont Department of Taxes within three business days of the due date. If you file electronically, the receipt date is the transmission date. HOMEOWNER DECEASED before April 1, 2022? The right to file for a Property Tax Credit ends if the homeowner dies before April 1, 2022. If a single homeowner has filed a claim before April 1 but then dies before April 1, the claim must be withdrawn using Form HS-122W. If, however, two homeowners have filed jointly before April 1, but then one of them dies before April 1, the claim belongs to the surviving homeowner. PURCHASED a home as your principal residence on or before April 1, 2022? You must file Form HS-122 Sections A and B to make a property tax credit claim. You can file online on our website at myVTax.vermont.gov. Amending Form HS-122 Certain lines of their Property Tax Credit claim form can be amended. This includes housesite value, housesite education tax, housesite municipal tax, ownership percentage, and household income. Original return must be filed timely. INJURED SPOUSE CLAIMS: To make an “injured spouse” claim, send the following information prior to filing your claim: 1. Copy of federal Form 8379, Injured Spouse Allocation (if you filed this form with the IRS) 2. A signed letter of request for your claim 3. Documentation of your ownership interest, for example, your deed Mail information to:

ATTN: Injured Spouse Unit

Vermont Department of Taxes

PO Box 1645

Montpelier VT 05601-1645

The Department will notify you if the property tax credit is taken to pay a bill. You have 30 days from the date on the notice to submit the injured spouse claim to the Department. Before you begin to file for the Property Tax Credit, you must first determine if you meet household income criteria. Complete Schedule HI-144, Household Income, to see if you are eligible for a credit. Schedule HI-144 must be submitted with Form HS-122. Lines B1 – B3 Eligibility Questions: Check the appropriate “Yes” or “No” box to answer the eligibility questions. ALL eligibility questions must be answered. Information for Lines B4-B6 is found on your 2021/2022 property tax bill. Line B4 Housesite Value: Enter the assessed housesite value shown on the 2021/2022 property tax bill. See the instructions under “Special Situations” for information on new construction or purchase of a new home. Line B5 Housesite Education Property Tax: Enter the education property tax shown on the 2021/2022 property tax bill. Line B6 Housesite Municipal Tax: Enter the municipal property tax shown on the 2021/2022 property tax bill.

37 tax.vermont.gov Line B7 Ownership Interest: Any person who meets eligibility requirements to file a Homestead Declaration should be included in the ownership interest. For example, if all owners are members of the household, occupying the property as their principal residence, enter 100%. If some owners are not members of the household, meaning they do not occupy the property as their principal residence, then ownership interest is the percentage of ownership for household members only. For example, if there are four owners but only two of them occupy the property as their principal residence, enter 50%. Line B8 Household Income: Enter the amount calculated on Schedule HI-144, Line z. If you are amending your Household Income Schedule, please mark the box with an “X.” Line B9 Lot Rent: If you rent a lot in a privately owned mobile home park, obtain Form LRC-147, Statement of Mobile Home Lot Rent, Co-Ops, and Trust, from your landlord and enter the amount of Allocable Rent. Lines B10 – B11 Allocated Tax from Land Trust, Cooperative, or Nonprofit Mobile Home Park: Enter the amount of education and municipal property tax shown on Form LRC-147 by the land trust, cooperative, or nonprofit mobile home park. Lines B12 – B13 Property Tax from Contiguous Property: If you own contiguous property, you may use the property taxes from that parcel if the property tax bill for your dwelling has under two acres or part of the dwelling or a building, such as a garage, is on the contiguous property. Signature: Sign the property tax credit claim. Date: Enter the date you sign the claim. Disclosure Authorization: Check this box if you wish to give the Vermont Department of Taxes authorization to discuss this claim with your tax preparer. Be sure the tax preparer’s name is included. This authorization will automatically end April 18, 2027. Preparer: If you are a paid preparer, you must sign this claim, enter your Social Security Number or PTIN, and if employed by a business, include the Federal Employer Identification Number of the business. If someone other than the homeowner prepared this claim without charging a fee, the preparer’s signature is optional. If mailing this return, send to:

Vermont Department of Taxes

PO Box 1881

Montpelier, VT 05601-1881 The maximum 2022 Property Tax Credit is $8,000.

The Property Tax Credit will appear as a state payment on your 2022/2023 property tax bill. SCHEDULE HI-144 Household Income Schedule Domicile For a definition of “domicile,” please refer to Reg. § 1.5811(11)(A)(i)-Domicile on our website. Homeowner You are the homeowner if you own and occupy the housesite as your principal residence. Household Income means modified Adjusted Gross Income, but not less than zero (0), received in a calendar year by all persons of a household while members of that household. Household Members include you, your spouse/civil union partner, roommates, and family members (including children) even if they file their own income tax returns and are not considered dependents. You must include a spouse/civil union partner as a member of your household even if your spouse/civil union partner does not live with you in the same home. If, however, your spouse/civil union partner does not live with you and you and your spouse/civil union partner are legally separated by court order, then this person is not considered a household member.

Exceptions - The following are not considered household members: • A spouse/civil union partner who is at least 62 years of age and who has moved to a nursing home or other care facility with no reasonable prospect of returning to the household • A person who is not related to any member of the household and who is living in the household under a written home sharing agreement with a nonprofit home sharing program authorized by the Vermont Department of Disabilities, Aging and Independent Living • A person living in the household who is a bona fide employee hired to provide personal care to a member of the household and who is not related to the person for whom the care is provided • A person who resides with you (the person filing the claim) for the primary reason of providing attendant care services or homemaker or companionship services with or without compensation that allows you to remain in your home or avoid institutionalization. To qualify for this exception, you must be disabled or 62 years of age or older as of Dec. 31, 2021.

38 tax.vermont.gov Members of the household for a portion of the year. You must include the income received by all persons residing in the home during the period they resided in the home. Household Income On Schedule HI-144, Lines a through n, list the items of income that are required to be reported for Household Income. • Report your income (if filing jointly, include the income of your spouse) under Column 1. • Report the income of your spouse or civil union partner if filing separately, under Column 2. Exceptions applying to spouse/civil union partner 1. You do not have to include your spouse/civil union partner when the person is not living with you as a member of your household and you are legally separated by court order or previously established protective/restraining order. 2. You do not have to include the income of a spouse who is age 62 or older and has moved permanently to a nursing home or other care facility. • You do not have to include the income of a spouse who has a court-ordered restraining order in place prohibiting contact with you. • Report the income of your spouse if filing separately, or civil union partner under Column 2.

Exclusions: The following are not part of household income: • Economic Impact Payments (federal stimulus checks/payments) • Paycheck Protection Program (PPP) loans that have been forgiven • Payments by the State of Vermont for foster care under Vermont law at 33 V.S.A. Chapters 49 and 55 • Payments by the State of Vermont to a family for the support of an eligible person with a developmental disability • Payments by the State of Vermont or an agency for adult foster care payments (formerly “difficulty of care” payments) found in 18 V.S.A. § 8907 • Surplus food or other relief in-kind supplied by a government agency • The first $6,500 of income received (earned or unearned) by a person who qualifies as a dependent of the claimant under the Internal Revenue Code and who is the claimant’s parent or disabled adult child • The first $6,500 of income earned, such as wages, salaries, tips, etc., by a full-time student who qualifies as a dependent of the claimant (all unearned income must be reported) • The first $6,500 of gifts of cash and/or cash equivalents received by all household members • Distributions from the contributions to a ROTH IRA (distributions from the earnings of the ROTH IRA are to be reported in household income) • Gifts from a nongovernmental source, such as aid provided by the Red Cross, Salvation Army, a church, to assist paying a living expense (for example, fuel, utilities, rent) • Any income that resulted from cancellation of debt. Refer to 32 V.S.A. § 6061(4)(B) Household Income Line a Cash public assistance and relief Enter all payments from the State of Vermont Agency of Human Services except for foster care payments, difficulty of care payments, food stamps, and fuel assistance. The first $6,500 of refugee settlement payment is excluded. Line b Social Security, Social Security Income (SSI), Social Security Disability Income (SSDI), railroad retirement, and veterans’ benefits (taxable and nontaxable) Enter payments from Social Security as reported in Box 5 of your SSA-1099 (this box adjusts for any repayment of Social Security benefits you were required to make) or from federal Form 1040, U.S. Individual Income Tax Return. Social Security benefits also include SSI and SSDI payments. Enter all railroad retirement from RRB-1099 and veteran’s benefits. Line c Unemployment compensation and workers’ compensation Enter the full unemployment compensation shown on Form 1099-G, Certain Government Payments, plus any workers’ compensation you received. Line d Wages, salaries, tips, etc. Enter the income shown on Form W-2, Box 1. Also report Form 1099-MISC, Miscellaneous Income, issued for nonemployee compensation if this is income not included as part of Line i, Business Income. See “Exclusions” in “Household Income” section before completing this line. Line e Interest and dividends Enter the income reported on federal Form 1040, Lines 2b and 3b. Line f Interest on U.S., state, or municipal obligations Enter the income reported on federal Form 1040, Line 2a, and all interest income from federal, state or municipal government bonds. This includes interest taxed at the federal level but exempted for Vermont income tax purposes and interest not taxed at the federal level. Line g Alimony, support money Enter the total received for alimony and support money. Support money includes payment of housing expenses for a household member or other financial assistance that makes it possible for the household member to live in the homestead or rental unit. Line h Child support and cash gifts List all child support payments received in the calendar year as well as all cash gifts. Cash gifts include any and all cash received by you or other household members, as well as cash equivalents. Cash

39 tax.vermont.gov equivalents include gifted stocks, bonds, treasury obligations, certificates of deposit or other household instruments convertible to cash.

Specify the type of income you are reporting on the indicated line. Line i Business income Enter income attributable to a business. If there is a business loss, leave blank. For taxpayers filing Married Filing Jointly, where both spouses have business income or loss from sole proprietorships, enter the amount from federal Form 1040 or leave blank if a negative, in the Claimant column. Line j Capital gains Report nontaxable gains from the sale of your home and gains from federal Schedule D, Capital Gains and Losses: A capital loss carryforward cannot be used to offset a current year capital gain. Add back federal Schedule D, Lines 6 and 14 to Line 16. This cannot be less than zero (0).

Exception: A business loss may offset a capital gain on the sale of the business’s property provided all three of the following are true for the business: (1) the loss and capital gain are for the same business; (2) the IRS requires the capital gain to be reported; and (3) the business loss and capital gain from the sale of the business’s property both occurred in the 2021 tax year. If the offset of the capital gain by the loss creates a negative amount, leave blank. A capital loss cannot offset business income. Line k Taxable pensions, annuities, IRAs, and retirement fund distributions. Enter the income from retirement, deferred compensation plans, and annuities as reported on federal Form 1040. Household income includes non- qualified distributions from retirement and deferred compensation plans and both taxable and nontaxable federal pension and annuity benefits. Line l Rental and Royalty income Enter the income from each rental property you own as reported on federal Schedule E, Supplemental Income and Loss, Part I. Each rental property stands on its own. A loss generated by one property may not be used to reduce income from a different property. Room and board payments received as difficulty of care payments for a member of your household are rental income and must be reported on this line. Report royalty income from federal Form 1099-MISC, Miscellaneous Income, 1099-S, Proceeds from Real Estate Transactions; Schedule K-1, Share of Income Deductions, Credits, etc.; or federal Schedule E, Supplemental Income and Loss, Part I. Line m Income from Partnerships, S Corporations, LLCs, Farms, Trusts and Estates Federal Schedule K-1 pass- through income as required to be reported on federal Schedules E and/or F, Profit or Loss from Farming. Report ordinary business income, rental income and guaranteed payments from K-1 on this line. The loss from one K-1 cannot offset income from another K-1. A loss is reported as -0-. See Line j instructions for the only provision allowing netting of a business loss. Line n Other income Sources of other income include, but are not limited to, prizes and awards, gambling or lottery winnings, director’s fees, employer allowances, taxable refunds from federal Form 1040, allowances received by dependents of armed service personnel and military subsistence payments (Basic Allowance for Housing, flexible spending arrangement or account), loss of time insurance, cost of living adjustment paid to federal employees, and other gains from federal Form 1040. Report on this line income reported to you on federal Form 1099-MISC or W-2G, Certain Gambling Winnings. For more information on military income, see the “Vermont Tax Guide for Military and National Services” available on the Department’s website. Line o Add items a through n by column. Carry those amounts over to the top of the next page. Adjustments to Income:

The following adjustments to household income may be made for each member of the household. Line p Social Security and Medicare Tax Withheld and Self-Employment Tax on Income Reported Social Security and Medicare payroll tax payments are deducted from household income, but only to the extent that the salary and wages are included in household income. Please see the examples that follow: 1. Deferred compensation – If you made a deferred compensation contribution for the tax year, the amount of the contribution is not included in the federal Adjusted Gross Income as stated on Form W-2, Box 1, Wage and Tax Statement. The Social Security and Medicare taxes on Form W-2 must be reduced for the purposes of reporting household income on Schedule HI-144. Generally, this amount is 7.65% of the amount stated on Form W-2, Box 1. 2. Military pay – Multiplying the amount stated on Form W-2, Box 1, by 7.65% provides the correct value for this deduction. 3. Allocated tips – In addition to the figures included on Form W-2, add the Social Security and Medicare payments you made as the result of completing federal Form 4137, Social Security and Medicare Tax On Unreported Tip Income.

Self-Employed Social Security and Medicare Taxes Paid Self-employed claimants may subtract from household income the amount from federal Schedule SE, Self-Employment Tax, Part I, Line 12, that represents the Social Security and Medicare taxes paid for 2021 for income reported on Schedule HI-144. For income not required to be reported upon which Social Security and Medicare taxes were paid, multiply the income not reported on Schedule HI-144 by 15.3% and subtract the result from the federal Schedule SE amount. The amount of Social

40 tax.vermont.gov Security and Medicare taxes reported on this line includes the allowable deduction for one-half self-employment tax on federal Form 1040, Schedule 1, Line 14. You may be asked for a copy of your federal Schedule SE. Line q Child support paid Report only those payments for which receipts or other evidence of payment is available. This evidence may include cancelled checks or a statement from the Office of Child Support in addition to the name and Social Security Number of the parent receiving the payment. Line r Allowable Adjustments from federal Schedule 1. The following expenses may be subtracted from income. r1. Certain business expenses of reservists r2. Alimony paid r3. Self-employed health insurance deduction r4. Health savings account deduction r5. Tuition and Fees as federally allowed Line s Add Lines p, q, and the total of Lines r1 through r5 for each column. Line t Subtract the total adjustments on Line s from the total income on Line o for each column. The adjustments for any individual in your household cannot exceed the income of that individual. If Line o minus Line s is negative, enter -0-. Line u Add columns 1, 2, and 3 and enter sum. Entry cannot be less than zero (0). Line v For claimants under the age of 65 as of Dec. 31, 2021, enter the total interest and dividends for all household members reported on Lines e and f in each column. Line w Add the three columns on Line v. Line x For purposes of calculating the Property Tax Credit, household income is increased by the household total of interest and dividend income greater than $10,000. Refer to V.S.A. § 6061(e). Line y Subtract Line x from Line w. If Line x is more than Line w, enter -0-. Line z Household Income. Add Line u and Line y. Enter this figure on Form HS-122. SPECIAL SITUATIONS Deceased Homeowner

Property Tax Credit: An estate cannot make a Property Tax Credit Claim on behalf of a deceased homeowner. If a homeowner files a Property Tax Credit Claim, but dies prior to April 1, 2022, the estate must withdraw the claim using Form HS-122W. The estate is responsible to repay any credit issued. If the homeowner filed a Property Tax Credit Claim between January 1 and March 31 and dies after April 1, 2022, the commissioner may pay the credit to the town on behalf of another member of the household with ownership interest.

An estate may continue classification of the property as a homestead until the following April provided the property was the deceased homeowner’s homestead at the time of death and the property is not rented. Delinquent Property Tax The 2022 property tax credit applies to the current year property tax. The municipality may use any remaining credit towards penalty, interest, or prior year property taxes. Nursing Home or Residential Care If the homeowner is age 62 or older and another owner who also lived in the homestead is the homeowner’s spouse/civil union partner or sibling and has moved indefinitely from the homestead to a nursing home or residential care facility, the homeowner makes the Property Tax Credit Claim with 100% ownership. This applies only if the spouse/civil union partner or sibling does not make a Renter Credit Claim or the spouse/civil union partner or sibling does not make a Property Tax Credit Claim for the same homestead.

If the homeowner has moved to a nursing home or residential care facility, a Property Tax Credit Claim may be made if there is a reasonable likelihood that the homeowner will be returning to the homestead and the homeowner does not make a Renter Credit Claim. The Department may ask for a doctor’s certificate to help determine whether the nursing home or residential care facility is a temporary location. Renting at the End of the Year You may be eligible for a Renter Credit Claim for rent paid in 2021 under the following circumstances: 1) If you owned a Vermont homestead in 2021, 2) sold the homestead before April 1, 2021, 3) withdrew or did not file a 2021 Property Tax Credit Claim and 4) rented between the date of the sale and Dec. 31, 2021.

41 tax.vermont.gov OWNERSHIP SITUATIONS Homeowner Age 62 or Older in 2021 If the homeowner shares ownership of the homestead with his or her descendant(s), the homeowner may claim 100% ownership interest on the Property Tax Credit Claim, even if the other owners (descendants) do not live in the homestead. The Department may request a letter of explanation. Divorced or Legally Separated Joint Owners When the divorce decree or court order has declared a specific percentage of home ownership for the purpose of property taxes, you must use that percentage if the following apply: 1) you are divorced or legally separated from your spouse/civil union partner; 2) your name and the name of the spouse/civil union partner from whom you are divorced or legally separated remain on the deed; and 3) you are awarded possession of the home. If the divorce decree or court order does not specify responsibility for the property taxes, the person residing in the homestead uses 50% ownership interest. The person not living in the homestead cannot make a Property Tax Credit Claim.

The Department may ask for a copy of your court documents. Duplex Housing Both owners occupy the building as their principal residence. The eligible housesite education property tax is the tax on the portion owned by each homeowner. If the town issues a property tax bill to each homeowner for his or her portion of the homestead, use the housesite value, housesite property tax, and 100% ownership interest. If the property tax bill is for the total property, prorate the housesite value, housesite property tax, and ownership interest.

Only one owner occupies the building as his or her principal residence. The owner occupying the duplex as his or her principal residence must prorate for the other owner’s interest. Entity Ownership Property owned by a C or S corporation, partnership, or limited liability company cannot be claimed as an individual’s homestead and is not eligible for property tax credit. The only exception is for a homestead located on a farm. Read Reg. § 1.5401(7)-Homestead at tax.vermont.gov/regulations. Life Estate A person who holds a life estate interest in a property that he or she occupies as a principal residence may make a Property Tax Credit Claim as if the life estate holder was the owner of the property. The deed does not have to be attached to the Property Tax Credit Claim but must be available for review upon Department request. Trust Ownership A dwelling owned by a trust is not the homestead of the beneficiary unless the claimant is the sole beneficiary of the trust and one of the following: 1. The claimant or the claimant’s spouse was the grantor of the trust, and the trust is revocable or became irrevocable solely by reason of the grantor’s death;

OR 2. The claimant is the parent, grandparent, child, grandchild or sibling of the grantor; the claimant is mentally disabled or severely physically disabled; and the grantor’s modified Adjusted Gross Income is included in the household income calculation.

The term “sole beneficiary” is satisfied if the homeowner and the spouse/civil union partner are the only beneficiaries of the trust. A property owned by an irrevocable trust cannot be a homestead except as stated in (1) above. The trust document does not have to be attached to the Property Tax Credit Claim but must be available for review upon Department request. BUYING and SELLING PROPERTY Buying after April 1, 2021 For property purchased as your principal residence, you need to file a 2022 Homestead Declaration. If you are eligible to make a 2022 Property Tax Credit Claim and the property was declared as a homestead, use the seller’s 2021/2022 property tax bill. If the property was not a homestead in 2021, ask the town for the housesite value and the property taxes on the housesite as if it was a homestead in 2021. Property Transactions after April 1, 2022 The property tax credit stays with the property. In the case of the sale or transfer of a residence, any property tax credit amounts related to that residence shall be allocated to the seller at closing unless the parties agree otherwise. NEW CONSTRUCTION

New homestead construction that was built after April 1, 2021, and is owned and occupied as a principal residence on April 1, 2022, must file Form HS-122 Homestead Declaration. Eligible homeowners may make a 2022 Property Tax Credit Claim. The claim will be based on the value of the parcel as of April 1, 2021.

42 tax.vermont.gov 2021 Vermont Tax Rate Schedules Example: VT Taxable Income is $82,000 (Form IN-111, Line 7). Filing Status is Married Filing Jointly. Use Schedule Y-1. Base Tax is $2,727. Subtract $75,000 from $82,000. Multiply the result ($7,000) by 6.6%. Add this amount ($462) to Base Tax ($2,727) for Vermont Tax of $3,189. Enter $3,189 on Form IN-111, Line 8. Please note: For Adjusted Gross Incomes (IN-111, Line 1) exceeding $150,000, Line 8 is the greater of 1) 3% of Adjusted Gross Income less interest from U.S. obligations, or 2) Tax Rate Schedule/Tax Table calculation. Single Individuals, Schedule X Use if your filing status is: Single

0 40,950 0.00 3.35% 0

40,950 75,000 1,372.00 6.60% 40,950 TAXABLE INCOME UNDER $75,000 USE THE TAX TABLES

75,000 99,200 3,619.00 6.60% 75,000

99,200 206,950 5,216.00 7.60% 99,200

206,950 - 13,405.00 8.75% 206,950 If VT Taxable But Not VT Base Plus of the Income is Over Over Tax is

amount over Married Filing Separately, Schedule Y-2 Use if your filing status is: Married Filing Separately; or Civil Union Filing Separately

0 34,200 0.00 3.35% 0

34,200 75,000 1,146.00 6.60% 34,200 TAXABLE INCOME UNDER $75,000 USE THE TAX TABLES

75,000 82,675 3,839.00 6.60% 75,000

82,675 125,975 4,345.00 7.60% 82,675 125,975 - 7,636.00 8.75% 125,975 If VT Taxable But Not VT Base Plus of the Income is Over Over Tax is

amount over Married Filing Jointly, Schedule Y-1 Use if your filing status is: Married Filing Jointly; Qualifying Widow(er); or Civil Union Filing Jointly

0 68,400 0.00 3.35% 0

68,400 75,000 2,291.00 6.60% 68,400 TAXABLE INCOME UNDER $75,000 USE THE TAX TABLES

75,000 165,350 2,727.00 6.60% 75,000

165,350 251,950 8,690.00 7.60% 165,350

251,950 - 15,272.00 8.75% 251,950 If VT Taxable But Not VT Base Plus of the Income is Over Over Tax is

amount over Heads of Household, Schedule Z Use if your filing status is: Head of Household

0 54,850 0.00 3.35% 0

54,850 75,000 1,837.00 6.60% 54,850 TAXABLE INCOME UNDER $75,000 USE THE TAX TABLES

75,000 141,700 3,167.00 6.60% 75,000 141,700 229,450 7,570.00 7.60% 141,700 229,450 - 14,239.00 8.75% 229,450 If VT Taxable But Not VT Base Plus of the Income is Over Over Tax is

amount over

43 * This column also applies to qualifying widow(er) and civil union filing jointly status ** This column also applies to civil union filing separately status 2021 Vermont Tax Tables 0-1,000

0 100 0 0 0 0

100 200 5 5 5 5

200 300 8 8 8 8

300 400 12 12 12 12

400 500 15 15 15 15

500 600 18 18 18 18

600 700 22 22 22 22

700 800 25 25 25 25

800 900 28 28 28 28

900 1,000 32 32 32 32 1,000

1,000 1,100 35 35 35 35 1,100 1,200 39 39 39 39 1,200 1,300 42 42 42 42 1,300 1,400 45 45 45 45 1,400 1,500 49 49 49 49 1,500 1,600 52 52 52 52 1,600 1,700 55 55 55 55 1,700 1,800 59 59 59 59 1,800 1,900 62 62 62 62 1,900 2,000 65 65 65 65 2,000

2,000 2,100 69 69 69 69 2,100 2,200 72 72 72 72 2,200 2,300 75 75 75 75 2,300 2,400 79 79 79 79 2,400 2,500 82 82 82 82 2,500 2,600 85 85 85 85 2,600 2,700 89 89 89 89 2,700 2,800 92 92 92 92 2,800 2,900 95 95 95 95 2,900 3,000 99 99 99 99 3,000

3,000 3,100 102 102 102 102 3,100 3,200 106 106 106 106 3,200 3,300 109 109 109 109 3,300 3,400 112 112 112 112 3,400 3,500 116 116 116 116 3,500 3,600 119 119 119 119 3,600 3,700 122 122 122 122 3,700 3,800 126 126 126 126 3,800 3,900 129 129 129 129 3,900 4,000 132 132 132 132 4,000

4,000 4,100 136 136 136 136 4,100 4,200 139 139 139 139 4,200 4,300 142 142 142 142 4,300 4,400 146 146 146 146 4,400 4,500 149 149 149 149 4,500 4,600 152 152 152 152 4,600 4,700 156 156 156 156 4,700 4,800 159 159 159 159 4,800 4,900 162 162 162 162 4,900 5,000 166 166 166 166 5,000

5,000 5,100 169 169 169 169 5,100 5,200 173 173 173 173 5,200 5,300 176 176 176 176 5,300 5,400 179 179 179 179 5,400 5,500 183 183 183 183 5,500 5,600 186 186 186 186 5,600 5,700 189 189 189 189 5,700 5,800 193 193 193 193 5,800 5,900 196 196 196 196 5,900 6,000 199 199 199 199 6,000

6,000 6,100 203 203 203 203 6,100 6,200 206 206 206 206 6,200 6,300 209 209 209 209 6,300 6,400 213 213 213 213 6,400 6,500 216 216 216 216 6,500 6,600 219 219 219 219 6,600 6,700 223 223 223 223 6,700 6,800 226 226 226 226 6,800 6,900 229 229 229 229 6,900 7,000 233 233 233 233 7,000

7,000 7,100 236 236 236 236 7,100 7,200 240 240 240 240 7,200 7,300 243 243 243 243 7,300 7,400 246 246 246 246 7,400 7,500 250 250 250 250 7,500 7,600 253 253 253 253 7,600 7,700 256 256 256 256 7,700 7,800 260 260 260 260 7,800 7,900 263 263 263 263 7,900 8,000 266 266 266 266 8,000

8,000 8,100 270 270 270 270 8,100 8,200 273 273 273 273 8,200 8,300 276 276 276 276 8,300 8,400 280 280 280 280 8,400 8,500 283 283 283 283 8,500 8,600 286 286 286 286 8,600 8,700 290 290 290 290 8,700 8,800 293 293 293 293 8,800 8,900 296 296 296 296 8,900 9,000 300 300 300 300 9,000

9,000 9,100 303 303 303 303 9,100 9,200 307 307 307 307 9,200 9,300 310 310 310 310 9,300 9,400 313 313 313 313 9,400 9,500 317 317 317 317 9,500 9,600 320 320 320 320 9,600 9,700 323 323 323 323 9,700 9,800 327 327 327 327 9,800 9,900 330 330 330 330 9,900 10,000 333 333 333 333 10,000

10,000 10,100 337 337 337 337 10,100 10,200 340 340 340 340 10,200 10,300 343 343 343 343 10,300 10,400 347 347 347 347 10,400 10,500 350 350 350 350 10,500 10,600 353 353 353 353 10,600 10,700 357 357 357 357 10,700 10,800 360 360 360 360 10,800 10,900 363 363 363 363 10,900 11,000 367 367 367 367 11,000

11,000 11,100 370 370 370 370 11,100 11,200 374 374 374 374 11,200 11,300 377 377 377 377 11,300 11,400 380 380 380 380 11,400 11,500 384 384 384 384 11,500 11,600 387 387 387 387 11,600 11,700 390 390 390 390 11,700 11,800 394 394 394 394 11,800 11,900 397 397 397 397 11,900 12,000 400 400 400 400 12,000

12,000 12,100 404 404 404 404 12,100 12,200 407 407 407 407 12,200 12,300 410 410 410 410 12,300 12,400 414 414 414 414 12,400 12,500 417 417 417 417 12,500 12,600 420 420 420 420 12,600 12,700 424 424 424 424 12,700 12,800 427 427 427 427 12,800 12,900 430 430 430 430 12,900 13,000 434 434 434 434 13,000

13,000 13,100 437 437 437 437 13,100 13,200 441 441 441 441 13,200 13,300 444 444 444 444 13,300 13,400 447 447 447 447 13,400 13,500 451 451 451 451 13,500 13,600 454 454 454 454 13,600 13,700 457 457 457 457 13,700 13,800 461 461 461 461 13,800 13,900 464 464 464 464 13,900 14,000 467 467 467 467 14,000

14,000 14,100 471 471 471 471 14,100 14,200 474 474 474 474 14,200 14,300 477 477 477 477 14,300 14,400 481 481 481 481 14,400 14,500 484 484 484 484 14,500 14,600 487 487 487 487 14,600 14,700 491 491 491 491 14,700 14,800 494 494 494 494 14,800 14,900 497 497 497 497 14,900 15,000 501 501 501 501 If Taxable Income is... And your filing status is... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your VT Tax is... If Taxable Income is... And your filing status is... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your VT Tax is... If Taxable Income is... And your filing status is... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your VT Tax is...

If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... 44 If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... * This column also applies to qualifying widow(er) and civil union filing jointly status ** This column also applies to civil union filing separately status 15,000

15,000 15,100 504 504 504 504 15,100 15,200 508 508 508 508 15,200 15,300 511 511 511 511 15,300 15,400 514 514 514 514 15,400 15,500 518 518 518 518 15,500 15,600 521 521 521 521 15,600 15,700 524 524 524 524 15,700 15,800 528 528 528 528 15,800 15,900 531 531 531 531 15,900 16,000 534 534 534 534 16,000

16,000 16,100 538 538 538 538 16,100 16,200 541 541 541 541 16,200 16,300 544 544 544 544 16,300 16,400 548 548 548 548 16,400 16,500 551 551 551 551 16,500 16,600 554 554 554 554 16,600 16,700 558 558 558 558 16,700 16,800 561 561 561 561 16,800 16,900 564 564 564 564 16,900 17,000 568 568 568 568 17,000

17,000 17,100 571 571 571 571 17,100 17,200 575 575 575 575 17,200 17,300 578 578 578 578 17,300 17,400 581 581 581 581 17,400 17,500 585 585 585 585 17,500 17,600 588 588 588 588 17,600 17,700 591 591 591 591 17,700 17,800 595 595 595 595 17,800 17,900 598 598 598 598 17,900 18,000 601 601 601 601 18,000

18,000 18,100 605 605 605 605 18,100 18,200 608 608 608 608 18,200 18,300 611 611 611 611 18,300 18,400 615 615 615 615 18,400 18,500 618 618 618 618 18,500 18,600 621 621 621 621 18,600 18,700 625 625 625 625 18,700 18,800 628 628 628 628 18,800 18,900 631 631 631 631 18,900 19,000 635 635 635 635 19,000

19,000 19,100 638 638 638 638 19,100 19,200 642 642 642 642 19,200 19,300 645 645 645 645 19,300 19,400 648 648 648 648 19,400 19,500 652 652 652 652 19,500 19,600 655 655 655 655 19,600 19,700 658 658 658 658 19,700 19,800 662 662 662 662 19,800 19,900 665 665 665 665 19,900 20,000 668 668 668 668 20,000

20,000 20,100 672 672 672 672 20,100 20,200 675 675 675 675 20,200 20,300 678 678 678 678 20,300 20,400 682 682 682 682 20,400 20,500 685 685 685 685 20,500 20,600 688 688 688 688 20,600 20,700 692 692 692 692 20,700 20,800 695 695 695 695 20,800 20,900 698 698 698 698 20,900 21,000 702 702 702 702 21,000

21,000 21,100 705 705 705 705 21,100 21,200 709 709 709 709 21,200 21,300 712 712 712 712 21,300 21,400 715 715 715 715 21,400 21,500 719 719 719 719 21,500 21,600 722 722 722 722 21,600 21,700 725 725 725 725 21,700 21,800 729 729 729 729 21,800 21,900 732 732 732 732 21,900 22,000 735 735 735 735 22,000

22,000 22,100 739 739 739 739 22,100 22,200 742 742 742 742 22,200 22,300 745 745 745 745 22,300 22,400 749 749 749 749 22,400 22,500 752 752 752 752 22,500 22,600 755 755 755 755 22,600 22,700 759 759 759 759 22,700 22,800 762 762 762 762 22,800 22,900 765 765 765 765 22,900 23,000 769 769 769 769 23,000

23,000 23,100 772 772 772 772 23,100 23,200 776 776 776 776 23,200 23,300 779 779 779 779 23,300 23,400 782 782 782 782 23,400 23,500 786 786 786 786 23,500 23,600 789 789 789 789 23,600 23,700 792 792 792 792 23,700 23,800 796 796 796 796 23,800 23,900 799 799 799 799 23,900 24,000 802 802 802 802 24,000

24,000 24,100 806 806 806 806 24,100 24,200 809 809 809 809 24,200 24,300 812 812 812 812 24,300 24,400 816 816 816 816 24,400 24,500 819 819 819 819 24,500 24,600 822 822 822 822 24,600 24,700 826 826 826 826 24,700 24,800 829 829 829 829 24,800 24,900 832 832 832 832 24,900 25,000 836 836 836 836 25,000

25,000 25,100 839 839 839 839 25,100 25,200 843 843 843 843 25,200 25,300 846 846 846 846 25,300 25,400 849 849 849 849 25,400 25,500 853 853 853 853 25,500 25,600 856 856 856 856 25,600 25,700 859 859 859 859 25,700 25,800 863 863 863 863 25,800 25,900 866 866 866 866 25,900 26,000 869 869 869 869 26,000

26,000 26,100 873 873 873 873 26,100 26,200 876 876 876 876 26,200 26,300 879 879 879 879 26,300 26,400 883 883 883 883 26,400 26,500 886 886 886 886 26,500 26,600 889 889 889 889 26,600 26,700 893 893 893 893 26,700 26,800 896 896 896 896 26,800 26,900 899 899 899 899 26,900 27,000 903 903 903 903 27,000

27,000 27,100 906 906 906 906 27,100 27,200 910 910 910 910 27,200 27,300 913 913 913 913 27,300 27,400 916 916 916 916 27,400 27,500 920 920 920 920 27,500 27,600 923 923 923 923 27,600 27,700 926 926 926 926 27,700 27,800 930 930 930 930 27,800 27,900 933 933 933 933 27,900 28,000 936 936 936 936 28,000

28,000 28,100 940 940 940 940 28,100 28,200 943 943 943 943 28,200 28,300 946 946 946 946 28,300 28,400 950 950 950 950 28,400 28,500 953 953 953 953 28,500 28,600 956 956 956 956 28,600 28,700 960 960 960 960 28,700 28,800 963 963 963 963 28,800 28,900 966 966 966 966 28,900 29,000 970 970 970 970 29,000

29,000 29,100 973 973 973 973 29,100 29,200 977 977 977 977 29,200 29,300 980 980 980 980 29,300 29,400 983 983 983 983 29,400 29,500 987 987 987 987 29,500 29,600 990 990 990 990 29,600 29,700 993 993 993 993 29,700 29,800 997 997 997 997 29,800 29,900 1000 1000 1000 1000 29,900 30,000 1003 1003 1003 1003

45 If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... * This column also applies to qualifying widow(er) and civil union filing jointly status ** This column also applies to civil union filing separately status 30,000

30,000 30,100 1007 1007 1007 1007 30,100 30,200 1010 1010 1010 1010 30,200 30,300 1013 1013 1013 1013 30,300 30,400 1017 1017 1017 1017 30,400 30,500 1020 1020 1020 1020 30,500 30,600 1023 1023 1023 1023 30,600 30,700 1027 1027 1027 1027 30,700 30,800 1030 1030 1030 1030 30,800 30,900 1033 1033 1033 1033 30,900 31,000 1037 1037 1037 1037 31,000

31,000 31,100 1040 1040 1040 1040 31,100 31,200 1044 1044 1044 1044 31,200 31,300 1047 1047 1047 1047 31,300 31,400 1050 1050 1050 1050 31,400 31,500 1054 1054 1054 1054 31,500 31,600 1057 1057 1057 1057 31,600 31,700 1060 1060 1060 1060 31,700 31,800 1064 1064 1064 1064 31,800 31,900 1067 1067 1067 1067 31,900 32,000 1070 1070 1070 1070 32,000

32,000 32,100 1074 1074 1074 1074 32,100 32,200 1077 1077 1077 1077 32,200 32,300 1080 1080 1080 1080 32,300 32,400 1084 1084 1084 1084 32,400 32,500 1087 1087 1087 1087 32,500 32,600 1090 1090 1090 1090 32,600 32,700 1094 1094 1094 1094 32,700 32,800 1097 1097 1097 1097 32,800 32,900 1100 1100 1100 1100 32,900 33,000 1104 1104 1104 1104 33,000

33,000 33,100 1107 1107 1107 1107 33,100 33,200 1111 1111 1111 1111 33,200 33,300 1114 1114 1114 1114 33,300 33,400 1117 1117 1117 1117 33,400 33,500 1121 1121 1121 1121 33,500 33,600 1124 1124 1124 1124 33,600 33,700 1127 1127 1127 1127 33,700 33,800 1131 1131 1131 1131 33,800 33,900 1134 1134 1134 1134 33,900 34,000 1137 1137 1137 1137 34,000

34,000 34,100 1141 1141 1141 1141 34,100 34,200 1144 1144 1144 1144 34,200 34,300 1147 1147 1149 1147 34,300 34,400 1151 1151 1156 1151 34,400 34,500 1154 1154 1163 1154 34,500 34,600 1157 1157 1169 1157 34,600 34,700 1161 1161 1176 1161 34,700 34,800 1164 1164 1182 1164 34,800 34,900 1167 1167 1189 1167 34,900 35,000 1171 1171 1196 1171 35,000

35,000 35,100 1174 1174 1202 1174 35,100 35,200 1178 1178 1209 1178 35,200 35,300 1181 1181 1215 1181 35,300 35,400 1184 1184 1222 1184 35,400 35,500 1188 1188 1229 1188 35,500 35,600 1191 1191 1235 1191 35,600 35,700 1194 1194 1242 1194 35,700 35,800 1198 1198 1248 1198 35,800 35,900 1201 1201 1255 1201 35,900 36,000 1204 1204 1262 1204 36,000

36,000 36,100 1208 1208 1268 1208 36,100 36,200 1211 1211 1275 1211 36,200 36,300 1214 1214 1281 1214 36,300 36,400 1218 1218 1288 1218 36,400 36,500 1221 1221 1295 1221 36,500 36,600 1224 1224 1301 1224 36,600 36,700 1228 1228 1308 1228 36,700 36,800 1231 1231 1314 1231 36,800 36,900 1234 1234 1321 1234 36,900 37,000 1238 1238 1328 1238 37,000

37,000 37,100 1241 1241 1334 1241 37,100 37,200 1245 1245 1341 1245 37,200 37,300 1248 1248 1347 1248 37,300 37,400 1251 1251 1354 1251 37,400 37,500 1255 1255 1361 1255 37,500 37,600 1258 1258 1367 1258 37,600 37,700 1261 1261 1374 1261 37,700 37,800 1265 1265 1380 1265 37,800 37,900 1268 1268 1387 1268 37,900 38,000 1271 1271 1394 1271 38,000

38,000 38,100 1275 1275 1400 1275 38,100 38,200 1278 1278 1407 1278 38,200 38,300 1281 1281 1413 1281 38,300 38,400 1285 1285 1420 1285 38,400 38,500 1288 1288 1427 1288 38,500 38,600 1291 1291 1433 1291 38,600 38,700 1295 1295 1440 1295 38,700 38,800 1298 1298 1446 1298 38,800 38,900 1301 1301 1453 1301 38,900 39,000 1305 1305 1460 1305 39,000

39,000 39,100 1308 1308 1466 1308 39,100 39,200 1312 1312 1473 1312 39,200 39,300 1315 1315 1479 1315 39,300 39,400 1318 1318 1486 1318 39,400 39,500 1322 1322 1493 1322 39,500 39,600 1325 1325 1499 1325 39,600 39,700 1328 1328 1506 1328 39,700 39,800 1332 1332 1512 1332 39,800 39,900 1335 1335 1519 1335 39,900 40,000 1338 1338 1526 1338 40,000

40,000 40,100 1342 1342 1532 1342 40,100 40,200 1345 1345 1539 1345 40,200 40,300 1348 1348 1545 1348 40,300 40,400 1352 1352 1552 1352 40,400 40,500 1355 1355 1559 1355 40,500 40,600 1358 1358 1565 1358 40,600 40,700 1362 1362 1572 1362 40,700 40,800 1365 1365 1578 1365 40,800 40,900 1368 1368 1585 1368 40,900 41,000 1372 1372 1592 1372 41,000

41,000 41,100 1379 1375 1598 1375 41,100 41,200 1385 1379 1605 1379 41,200 41,300 1392 1382 1611 1382 41,300 41,400 1398 1385 1618 1385 41,400 41,500 1405 1389 1625 1389 41,500 41,600 1412 1392 1631 1392 41,600 41,700 1418 1395 1638 1395 41,700 41,800 1425 1399 1644 1399 41,800 41,900 1431 1402 1651 1402 41,900 42,000 1438 1405 1658 1405 42,000

42,000 42,100 1445 1409 1664 1409 42,100 42,200 1451 1412 1671 1412 42,200 42,300 1458 1415 1677 1415 42,300 42,400 1464 1419 1684 1419 42,400 42,500 1471 1422 1691 1422 42,500 42,600 1478 1425 1697 1425 42,600 42,700 1484 1429 1704 1429 42,700 42,800 1491 1432 1710 1432 42,800 42,900 1497 1435 1717 1435 42,900 43,000 1504 1439 1724 1439 43,000

43,000 43,100 1511 1442 1730 1442 43,100 43,200 1517 1446 1737 1446 43,200 43,300 1524 1449 1743 1449 43,300 43,400 1530 1452 1750 1452 43,400 43,500 1537 1456 1757 1456 43,500 43,600 1544 1459 1763 1459 43,600 43,700 1550 1462 1770 1462 43,700 43,800 1557 1466 1776 1466 43,800 43,900 1563 1469 1783 1469 43,900 44,000 1570 1472 1790 1472 44,000

44,000 44,100 1577 1476 1796 1476 44,100 44,200 1583 1479 1803 1479 44,200 44,300 1590 1482 1809 1482 44,300 44,400 1596 1486 1816 1486 44,400 44,500 1603 1489 1823 1489 44,500 44,600 1610 1492 1829 1492 44,600 44,700 1616 1496 1836 1496 44,700 44,800 1623 1499 1842 1499 44,800 44,900 1629 1502 1849 1502 44,900 45,000 1636 1506 1856 1506

If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... 46 If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... * This column also applies to qualifying widow(er) and civil union filing jointly status ** This column also applies to civil union filing separately status 45,000

45,000 45,100 1643 1509 1862 1509 45,100 45,200 1649 1513 1869 1513 45,200 45,300 1656 1516 1875 1516 45,300 45,400 1662 1519 1882 1519 45,400 45,500 1669 1523 1889 1523 45,500 45,600 1676 1526 1895 1526 45,600 45,700 1682 1529 1902 1529 45,700 45,800 1689 1533 1908 1533 45,800 45,900 1695 1536 1915 1536 45,900 46,000 1702 1539 1922 1539 46,000

46,000 46,100 1709 1543 1928 1543 46,100 46,200 1715 1546 1935 1546 46,200 46,300 1722 1549 1941 1549 46,300 46,400 1728 1553 1948 1553 46,400 46,500 1735 1556 1955 1556 46,500 46,600 1742 1559 1961 1559 46,600 46,700 1748 1563 1968 1563 46,700 46,800 1755 1566 1974 1566 46,800 46,900 1761 1569 1981 1569 46,900 47,000 1768 1573 1988 1573 47,000

47,000 47,100 1775 1576 1994 1576 47,100 47,200 1781 1580 2001 1580 47,200 47,300 1788 1583 2007 1583 47,300 47,400 1794 1586 2014 1586 47,400 47,500 1801 1590 2021 1590 47,500 47,600 1808 1593 2027 1593 47,600 47,700 1814 1596 2034 1596 47,700 47,800 1821 1600 2040 1600 47,800 47,900 1827 1603 2047 1603 47,900 48,000 1834 1606 2054 1606 48,000

48,000 48,100 1841 1610 2060 1610 48,100 48,200 1847 1613 2067 1613 48,200 48,300 1854 1616 2073 1616 48,300 48,400 1860 1620 2080 1620 48,400 48,500 1867 1623 2087 1623 48,500 48,600 1874 1626 2093 1626 48,600 48,700 1880 1630 2100 1630 48,700 48,800 1887 1633 2106 1633 48,800 48,900 1893 1636 2113 1636 48,900 49,000 1900 1640 2120 1640 49,000

49,000 49,100 1907 1643 2126 1643 49,100 49,200 1913 1647 2133 1647 49,200 49,300 1920 1650 2139 1650 49,300 49,400 1926 1653 2146 1653 49,400 49,500 1933 1657 2153 1657 49,500 49,600 1940 1660 2159 1660 49,600 49,700 1946 1663 2166 1663 49,700 49,800 1953 1667 2172 1667 49,800 49,900 1959 1670 2179 1670 49,900 50,000 1966 1673 2186 1673 50,000

50,000 50,100 1973 1677 2192 1677 50,100 50,200 1979 1680 2199 1680 50,200 50,300 1986 1683 2205 1683 50,300 50,400 1992 1687 2212 1687 50,400 50,500 1999 1690 2219 1690 50,500 50,600 2006 1693 2225 1693 50,600 50,700 2012 1697 2232 1697 50,700 50,800 2019 1700 2238 1700 50,800 50,900 2025 1703 2245 1703 50,900 51,000 2032 1707 2252 1707 51,000

51,000 51,100 2039 1710 2258 1710 51,100 51,200 2045 1714 2265 1714 51,200 51,300 2052 1717 2271 1717 51,300 51,400 2058 1720 2278 1720 51,400 51,500 2065 1724 2285 1724 51,500 51,600 2072 1727 2291 1727 51,600 51,700 2078 1730 2298 1730 51,700 51,800 2085 1734 2304 1734 51,800 51,900 2091 1737 2311 1737 51,900 52,000 2098 1740 2318 1740 52,000

52,000 52,100 2105 1744 2324 1744 52,100 52,200 2111 1747 2331 1747 52,200 52,300 2118 1750 2337 1750 52,300 52,400 2124 1754 2344 1754 52,400 52,500 2131 1757 2351 1757 52,500 52,600 2138 1760 2357 1760 52,600 52,700 2144 1764 2364 1764 52,700 52,800 2151 1767 2370 1767 52,800 52,900 2157 1770 2377 1770 52,900 53,000 2164 1774 2384 1774 53,000

53,000 53,100 2171 1777 2390 1777 53,100 53,200 2177 1781 2397 1781 53,200 53,300 2184 1784 2403 1784 53,300 53,400 2190 1787 2410 1787 53,400 53,500 2197 1791 2417 1791 53,500 53,600 2204 1794 2423 1794 53,600 53,700 2210 1797 2430 1797 53,700 53,800 2217 1801 2436 1801 53,800 53,900 2223 1804 2443 1804 53,900 54,000 2230 1807 2450 1807 54,000

54,000 54,100 2237 1811 2456 1811 54,100 54,200 2243 1814 2463 1814 54,200 54,300 2250 1817 2469 1817 54,300 54,400 2256 1821 2476 1821 54,400 54,500 2263 1824 2483 1824 54,500 54,600 2270 1827 2489 1827 54,600 54,700 2276 1831 2496 1831 54,700 54,800 2283 1834 2502 1834 54,800 54,900 2289 1837 2509 1837 54,900 55,000 2296 1841 2516 1844 55,000

55,000 55,100 2303 1844 2522 1850 55,100 55,200 2309 1848 2529 1857 55,200 55,300 2316 1851 2535 1863 55,300 55,400 2322 1854 2542 1870 55,400 55,500 2329 1858 2549 1877 55,500 55,600 2336 1861 2555 1883 55,600 55,700 2342 1864 2562 1890 55,700 55,800 2349 1868 2568 1896 55,800 55,900 2355 1871 2575 1903 55,900 56,000 2362 1874 2582 1910 56,000

56,000 56,100 2369 1878 2588 1916 56,100 56,200 2375 1881 2595 1923 56,200 56,300 2382 1884 2601 1929 56,300 56,400 2388 1888 2608 1936 56,400 56,500 2395 1891 2615 1943 56,500 56,600 2402 1894 2621 1949 56,600 56,700 2408 1898 2628 1956 56,700 56,800 2415 1901 2634 1962 56,800 56,900 2421 1904 2641 1969 56,900 57,000 2428 1908 2648 1976 57,000

57,000 57,100 2435 1911 2654 1982 57,100 57,200 2441 1915 2661 1989 57,200 57,300 2448 1918 2667 1995 57,300 57,400 2454 1921 2674 2002 57,400 57,500 2461 1925 2681 2009 57,500 57,600 2468 1928 2687 2015 57,600 57,700 2474 1931 2694 2022 57,700 57,800 2481 1935 2700 2028 57,800 57,900 2487 1938 2707 2035 57,900 58,000 2494 1941 2714 2042 58,000

58,000 58,100 2501 1945 2720 2048 58,100 58,200 2507 1948 2727 2055 58,200 58,300 2514 1951 2733 2061 58,300 58,400 2520 1955 2740 2068 58,400 58,500 2527 1958 2747 2075 58,500 58,600 2534 1961 2753 2081 58,600 58,700 2540 1965 2760 2088 58,700 58,800 2547 1968 2766 2094 58,800 58,900 2553 1971 2773 2101 58,900 59,000 2560 1975 2780 2108 59,000

59,000 59,100 2567 1978 2786 2114 59,100 59,200 2573 1982 2793 2121 59,200 59,300 2580 1985 2799 2127 59,300 59,400 2586 1988 2806 2134 59,400 59,500 2593 1992 2813 2141 59,500 59,600 2600 1995 2819 2147 59,600 59,700 2606 1998 2826 2154 59,700 59,800 2613 2002 2832 2160 59,800 59,900 2619 2005 2839 2167 59,900 60,000 2626 2008 2846 2174

47 If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... If Taxable Income is ... And your filing status is ... At Least But Less Single Married Married Head of

Than

filing filing house-

jointly* sepa- hold

rately**

Then your Vermont Tax is ... * This column also applies to qualifying widow(er) and civil union filing jointly status ** This column also applies to civil union filing separately status 60,000

60,000 60,100 2633 2012 2852 2180 60,100 60,200 2639 2015 2859 2187 60,200 60,300 2646 2018 2865 2193 60,300 60,400 2652 2022 2872 2200 60,400 60,500 2659 2025 2879 2207 60,500 60,600 2666 2028 2885 2213 60,600 60,700 2672 2032 2892 2220 60,700 60,800 2679 2035 2898 2226 60,800 60,900 2685 2038 2905 2233 60,900 61,000 2692 2042 2912 2240 61,000

61,000 61,100 2699 2045 2918 2246 61,100 61,200 2705 2049 2925 2253 61,200 61,300 2712 2052 2931 2259 61,300 61,400 2718 2055 2938 2266 61,400 61,500 2725 2059 2945 2273 61,500 61,600 2732 2062 2951 2279 61,600 61,700 2738 2065 2958 2286 61,700 61,800 2745 2069 2964 2292 61,800 61,900 2751 2072 2971 2299 61,900 62,000 2758 2075 2978 2306 62,000

62,000 62,100 2765 2079 2984 2312 62,100 62,200 2771 2082 2991 2319 62,200 62,300 2778 2085 2997 2325 62,300 62,400 2784 2089 3004 2332 62,400 62,500 2791 2092 3011 2339 62,500 62,600 2798 2095 3017 2345 62,600 62,700 2804 2099 3024 2352 62,700 62,800 2811 2102 3030 2358 62,800 62,900 2817 2105 3037 2365 62,900 63,000 2824 2109 3044 2372 63,000

63,000 63,100 2831 2112 3050 2378 63,100 63,200 2837 2116 3057 2385 63,200 63,300 2844 2119 3063 2391 63,300 63,400 2850 2122 3070 2398 63,400 63,500 2857 2126 3077 2405 63,500 63,600 2864 2129 3083 2411 63,600 63,700 2870 2132 3090 2418 63,700 63,800 2877 2136 3096 2424 63,800 63,900 2883 2139 3103 2431 63,900 64,000 2890 2142 3110 2438 64,600

64,000 64,100 2897 2146 3116 2444 64,100 64,200 2903 2149 3123 2451 64,200 64,300 2910 2152 3129 2457 64,300 64,400 2916 2156 3136 2464 64,400 64,500 2923 2159 3143 2471 64,500 64,600 2930 2162 3149 2477 64,600 64,700 2936 2166 3156 2484 64,700 64,800 2943 2169 3162 2490 64,800 64,900 2949 2172 3169 2497 64,900 65,000 2956 2176 3176 2504 65,000

65,000 65,100 2963 2179 3182 2510 65,100 65,200 2969 2183 3189 2517 65,200 65,300 2976 2186 3195 2523 65,300 65,400 2982 2189 3202 2530 65,400 65,500 2989 2193 3209 2537 65,500 65,600 2996 2196 3215 2543 65,600 65,700 3002 2199 3222 2550 65,700 65,800 3009 2203 3228 2556 65,800 65,900 3015 2206 3235 2563 65,900 66,000 3022 2209 3242 2570 66,000

66,000 66,100 3029 2213 3248 2576 66,100 66,200 3035 2216 3255 2583 66,200 66,300 3042 2219 3261 2589 66,300 66,400 3048 2223 3268 2596 66,400 66,500 3055 2226 3275 2603 66,500 66,600 3062 2229 3281 2609 66,600 66,700 3068 2233 3288 2616 66,700 66,800 3075 2236 3294 2622 66,800 66,900 3081 2239 3301 2629 66,900 67,000 3088 2243 3308 2636 67,000

67,000 67,100 3095 2246 3314 2642 67,100 67,200 3101 2250 3321 2649 67,200 67,300 3108 2253 3327 2655 67,300 67,400 3114 2256 3334 2662 67,400 67,500 3121 2260 3341 2669 67,500 67,600 3128 2263 3347 2675 67,600 67,700 3134 2266 3354 2682 67,700 67,800 3141 2270 3360 2688 67,800 67,900 3147 2273 3367 2695 67,900 68,000 3154 2276 3374 2702 68,000

68,000 68,100 3161 2280 3380 2708 68,100 68,200 3167 2283 3387 2715 68,200 68,300 3174 2286 3393 2721 68,300 68,400 3180 2290 3400 2728 68,400 68,500 3187 2294 3407 2735 68,500 68,600 3194 2301 3413 2741 68,600 68,700 3200 2308 3420 2748 68,700 68,800 3207 2314 3426 2754 68,800 68,900 3213 2321 3433 2761 68,900 69,000 3220 2327 3440 2768 69,000

69,000 69,100 3227 2334 3446 2774 69,100 69,200 3233 2341 3453 2781 69,200 69,300 3240 2347 3459 2787 69,300 69,400 3246 2354 3466 2794 69,400 69,500 3253 2360 3473 2801 69,500 69,600 3260 2367 3479 2807 69,600 69,700 3266 2374 3486 2814 69,700 69,800 3273 2380 3492 2820 69,800 69,900 3279 2387 3499 2827 69,900 70,000 3286 2393 3506 2834 70,000

70,000 70,100 3293 2400 3512 2840 70,100 70,200 3299 2407 3519 2847 70,200 70,300 3306 2413 3525 2853 70,300 70,400 3312 2420 3532 2860 70,400 70,500 3319 2426 3539 2867 70,500 70,600 3326 2433 3545 2873 70,600 70,700 3332 2440 3552 2880 70,700 70,800 3339 2446 3558 2886 70,800 70,900 3345 2453 3565 2893 70,900 71,000 3352 2459 3572 2900 71,000

71,000 71,100 3359 2466 3578 2906 71,100 71,200 3365 2473 3585 2913 71,200 71,300 3372 2479 3591 2919 71,300 71,400 3378 2486 3598 2926 71,400 71,500 3385 2492 3605 2933 71,500 71,600 3392 2499 3611 2939 71,600 71,700 3398 2506 3618 2946 71,700 71,800 3405 2512 3624 2952 71,800 71,900 3411 2519 3631 2959 71,900 72,000 3418 2525 3638 2966 72,000

72,000 72,100 3425 2532 3644 2972 72,100 72,200 3431 2539 3651 2979 72,200 72,300 3438 2545 3657 2985 72,300 72,400 3444 2552 3664 2992 72,400 72,500 3451 2558 3671 2999 72,500 72,600 3458 2565 3677 3005 72,600 72,700 3464 2572 3684 3012 72,700 72,800 3471 2578 3690 3018 72,800 72,900 3477 2585 3697 3025 72,900 73,000 3484 2591 3704 3032 73,000

73,000 73,100 3491 2598 3710 3038 73,100 73,200 3497 2605 3717 3045 73,200 73,300 3504 2611 3723 3051 73,300 73,400 3510 2618 3730 3058 73,400 73,500 3517 2624 3737 3065 73,500 73,600 3524 2631 3743 3071 73,600 73,700 3530 2638 3750 3078 73,700 73,800 3537 2644 3756 3084 73,800 73,900 3543 2651 3763 3091 73,900 74,000 3550 2657 3770 3098 74,000

74,000 74,100 3557 2664 3776 3104 74,100 74,200 3563 2671 3783 3111 74,200 74,300 3570 2677 3789 3117 74,300 74,400 3576 2684 3796 3124 74,400 74,500 3583 2690 3803 3131 74,500 74,600 3590 2697 3809 3137 74,600 74,700 3596 2704 3816 3144 74,700 74,800 3603 2710 3822 3150 74,800 74,900 3609 2717 3829 3157 74,900 75,000 3616 2723 3836 3164

tax.vermont.gov Index Due Dates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Frequently Asked Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 General Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Identity Theft and Tax Scams. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Lifeline Telephone Service Credit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Low Income Child and Dependent Care Worksheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Medical Deduction Worksheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Online Filing Options with myVTax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Rate Schedules. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 School District Codes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Social Security Exemption Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Tax Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Taxpayer Advocate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Taxpayer Assistance and Contact Information. . . . . . . . . . . . . . . . . . . . . . . . . . . Front Cover Use Tax Reporting Table and Worksheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Voluntary Contributions – Descriptions of Organizations. . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Who is Eligible to File the Homestead Declaration, Property Tax Credit Claim, and Renter Credit Claim?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Who Must File a Vermont Income Tax Return?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Forms and Schedules Forms are in the center of the booklet. Form Number Title

Instructions IN-111 ������������ Income Tax Return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 IN-112 ������������ Vermont Tax Adjustments and Credits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 IN-113 ������������ Income Adjustment Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 HS-122 ����������� Homestead Declaration and Property Tax Credit Claim. . . . . . . . . . . . . . . 35 RCC-146 ��������� Renter Credit Claim. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 HI-144 ������������ Household Income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

tax.vermont.gov 2021 Vermont Tax Rate Schedules Example: VT Taxable Income is $82,000 (Form IN-111, Line 7). Filing Status is Married Filing Jointly. Use Schedule Y-1. Base Tax is $2,727. Subtract $75,000 from $82,000. Multiply the result ($7,000) by 6.6%. Add this amount ($462) to Base Tax ($2,727) for Vermont Tax of $3,189. Enter $3,189 on Form IN-111, Line 8. Please note: For Adjusted Gross Incomes (IN-111, Line 1) exceeding $150,000, Line 8 is the greater of 1) 3% of Adjusted Gross Income less interest from U.S. obligations, or 2) Tax Rate Schedule/Tax Table calculation. Single Individuals, Schedule X Use if your filing status is: Single 0 40,950 0.00 3.35% 0

40,950 75,000 1,372.00 6.60% 40,950 TAXABLE INCOME UNDER $75,000 USE THE TAX TABLES 75,000 99,200 3,619.00 6.60% 75,000

99,200 206,950 5,216.00 7.60% 99,200

206,950 - 13,405.00 8.75% 206,950 If VT Taxable But Not VT Base Plus of the Income is Over Over Tax is amount over Married Filing Separately, Schedule Y-2 Use if your filing status is: Married Filing Separately; or Civil Union Filing Separately 0 34,200 0.00 3.35% 0 34,200 75,000 1,146.00 6.60% 34,200 TAXABLE INCOME UNDER $75,000 USE THE TAX TABLES 75,000 82,675 3,839.00 6.60% 75,000

82,675 125,975 4,345.00 7.60% 82,675 125,975 - 7,636.00 8.75% 125,975 If VT Taxable But Not VT Base Plus of the Income is Over Over Tax is amount over Married Filing Jointly, Schedule Y-1 Use if your filing status is: Married Filing Jointly; Qualifying Widow(er); or Civil Union Filing Jointly 0 68,400 0.00 3.35% 0

68,400 75,000 2,291.00 6.60% 68,400 TAXABLE INCOME UNDER $75,000 USE THE TAX TABLES 75,000 165,350 2,727.00 6.60% 75,000

165,350 251,950 8,690.00 7.60% 165,350

251,950 - 15,272.00 8.75% 251,950 If VT Taxable But Not VT Base Plus of the Income is Over Over Tax is amount over Heads of Household, Schedule Z Use if your filing status is: Head of Household 0 54,850 0.00 3.35% 0

54,850 75,000 1,837.00 6.60% 54,850 TAXABLE INCOME UNDER $75,000 USE THE TAX TABLES 75,000 141,700 3,167.00 6.60% 75,000 141,700 229,450 7,570.00 7.60% 141,700 229,450 - 14,239.00 8.75% 229,450 If VT Taxable But Not VT Base Plus of the Income is Over Over Tax is amount over