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 *

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