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 2022? . . . . . . . 2. 3. Were you claimed as a dependent by another taxpayer in 2022? . . . 3. 4. Did you rent in Vermont for six months or more in 2022? . . . . . . . . 4. If you are eligible for a Renter Credit, complete Lines 5 through 14. 5. Did you share your rental unit with another adult who was not your jointly filed spouse?. . . . . . . . . . . . . . . . . . . . . . . 5. 6. Was your rent subsidized? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.

6a. If “Yes”, how many months was your rent subsidized in 2022?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6a. ____________________ 7. Number of months rented in 2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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. Did you file a federal income tax return? (See the instructions if you answered “No.”) . . . . . . . . . . . . . . . . . . . . . . . . 9. 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. 10/22 Vermont Department of Taxes 2022 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. *221461100* * 2 2 1 4 6 1 1 0 0 * For the year Jan. 1 - Dec. 31, 2022 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 12/31/2022 Unit City/Town of Rental Unit on 12/31/2022 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 5454 Clear ALL fields Save and go to Important Printing Instructions Save and Print