Form IN-111-IN-112 Fillable Vermont Income Tax Return & Adjustments and Credits
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00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 0010 check indicate indicate (: CU Joint) Unchecked (: CU Separate) Unchecked (: Head of Household) Unchecked (: Joint) Unchecked (: Married Separate) Unchecked (: No) Unchecked (: Single) Unchecked (: Widow) Unchecked (: Yes) Unchecked (1040 Line 48; 1040A Line 29) 8 (1040 Line 8b or 1040A Line 8b) 1 (32 V S A 5828) 3 (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (Clear ALL data fields) Clear ALL fields (Click here for printing instructions) Important Printing Instructions (Enter just the 9 digits no hyphens or spaces) (Enter just the 9 digits no hyphens or spaces) (Enter Spouse or CU Partner's name ONLY if filing separately) (Enter the 3 digit School Code) (Enter the 5 digit ZIP Code) (Enter the number of exemptions claimed) (Enter the number of qualifying children under the age of 18) (Enter the number of qualifying children) (From Federal Form 3468) 10 (From Federal Form 4255) 2 (From worksheet on page 11 of income tax booklet) 11 (If you are filing separately Enter just the 9 digits of the Spouse or CU partner no hyphens or spaces) (Middle Initial) (Print) Print (Schedule IN 117 Line 21) (See instructions on page 9) 31g (Spouse/CU Partner's Middle Initial) (Subtract Line 14d from Line 13 If Line 14d is more than Line 13 enter zero ) 15 (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) 0 *131111100* *131111200* *131121100* *131121200* 1 Earned income tax credit from Federal Form 1040 Line 64a; 1040A Line 38a; or 1040EZ Line 8a 1 1 Taxpayer s Last Name 1 VT School Code 10 Investment Tax Credit VT based only 1040A Line 38a; or 1040EZ Line 8a 7 1040EZ Line 6) If the Federal amount is zero see instructions on page 6 11 VT Farm Income Averaging Credit 12 Add Lines 8 through 11 12 12a Income from Non VT State and Local Obligations (Schedule IN 112 Part I Line 3) 12a 12b Bonus Depreciation allowed under Federal law for 2013 12c Addback of State and Local Income Taxes (Schedule IN 154 Line 10) 13 FEDERAL TAXABLE INCOME WITH ADDITIONS (Add Lines 11 12a 12b and 12c) 13 Multiply Line 12 by 24% 13 14 VT based Business Solar Energy Credit carryforward 14 14a Interest Income from U S Obligations 14b Capital Gains Exclusion (Schedule IN 153 Line 21) 14b 14c Adjustment for prior years Bonus Depreciation 14c 14d Add Lines 14a 14b and 14c 14d 15 Add Lines 13 and 14 Enter on Form IN 111 Line 19 15 17 ADDITIONS TO VT INCOME TAX (Schedule IN 112 Part II Line 7) 17 17Form IN 111* 18 VT INCOME TAX WITH ADDITIONS (Add Lines 16 & 17) 18 19 SUBTRACTIONS FROM VT INCOME TAX (Schedule IN 112 Part II Line 15) 19 2 911 street address on 12/31/2013 Number street/road name (Do not use PO Box same or Town name) 2 Interest and dividend income from VT state and local obligations included in Line 1 2 2 VT EARNED INCOME TAX CREDIT (Multiply Line 1 by 32%) Enter amount on Form IN 111 Line 31c 20 VT INCOME TAX (Subtract Line 19 from Line 18 If Line 19 is more than Line 18 enter zero) 20 2013 Contribution 23 24 25 26 VT INCOME TAX AFTER CREDITS (Subtract Line 25 from Line 22 If Line 25 is more than Line 22 enter zero ) 26 27 USE TAX (See page 8 for instructions and chart) 27 28 TOTAL VT TAXES (Add Lines 26 and 27) 28 29a 29b 29c 29d 3 Single 4 Head of 5 Married 6 CU Partner 7 Qualifying 3 Wages salaries tips etc (Schedule IN 113 Line 1) 3 30 TOTAL OF VT TAXES & VOLUNTARY CONTRIBUTIONS (Add Lines 28 and 29d) 30 31a From W 2 1099 etc VT Tax Withheld 31a 31b From VT Form IN 114 Estimated Tax for 2013 and/orForm IN 151 Extension with payment 31b 31c Earned Income Tax Credit (Schedule IN 112 Part III) 31c 31d Renter Rebate (Form PR 141 Line 9) 31d 31e From VT Form RW 171 VT Real Estate Withholding (seeinstructions on page 8) 31e 31f From VT Form WH 435 Estimated Income Tax Paymentmade by Business Entity for Nonresident Partner 31g Low Income Child & Dependent Care Credit 31h TOTAL PAYMENTS AND CREDITS (Add Lines 31a through 31g) 31h 32 OVERPAYMENT If Line 30 is less than Line 31h subtract Line 30 from Line 31h 32 33a REFUND TO BE CREDITED TO 2014 ESTIMATED TAX PAYMENT 33b REFUND TO BE CREDITED TO 2014 PROPERTY TAX BILL 33b 34 REFUND AMOUNT (Subtract Lines 33a and 33b from Line 32) 34 35 If Line 30 is more than Line 31h subtract Line 31h from Line 30 See page 9 for instructions on tax due 35 37 Add Lines 35 4 Other earned income (Schedule IN 113 5 Total earned income (Add Lines 3 & 4) 5 5454To claim refund mail to: 6 Earned income tax credit adjustment (Divide Line 5B by Line 5A and enter here but not more than 100%) 6 TOTAL CREDITS (Add Column C Lines 1 5) If you have credits from Schedule IN 119 (see page 12) thisamount is entered on Schedule IN 119 If you do NOT have credits from Schedule IN 119 enter this amount on 8 Multiply Line 7 by 32% and enter the result here 8 8a Married 8b CU 9 VT EARNED INCOME TAX CREDIT (Multiply Line 8 by Line 6 ) Enter amount on Form IN 111 Line 31c A Enter number of qualifying children A A Federal Amount $ a VT resident as shown on Schedule Add Lines 1 through 3 4 Add Lines 5 and 6 Enter on Form IN 111 Line 17 7 ADDITIONS TO VT TAX: ADDITIONS: ADJUSTED GROSS INCOME (Federal Form 1040 Line 37; 1040A Line 21; 1040EZ Line 4) ADJUSTED VT INCOME TAX (Multiply Line 20 by Line 21) Amount on 31d cannot be credited to 2014 estimated tax payment 33a an AMENDED return and 36 37 and belief they are true correct and complete Preparers cannot use return information for purposes other than preparing returns and Credits B Enter number of qualifying children under the age of 18 B B VT Portion $ C Were you (or your spouse if filing a joint return) at least age 25 but under age 65 at the end of 2013? cYes cNo Carryforward cc++= Charitable Housing (32 V S A 5830c) 2 Check here if authorizing the VT Department of Taxes to discuss this return and attachments with your preparer Check here if this is Check here if using RECOMPUTED Check here to certify that no Use Tax is due Check if age65 or older Check if Spouse or CU Partner Check if taxpayer Check to Check to Check to Column A PLUS (+) Column B EQUALS (=) Column C Column C Continued on back Continued on back Contributions Credit Credit for Child & Dependent Care Expenses CREDIT FOR INCOME TAX PAID TO OTHER VT TAX CREDITS (Schedule IN 112 TOTAL VT CREDITS Credit for the Elderly or the Disabled (Federal Schedule R) 9 Credits and Use Tax Credits for Lines 2 5 earned through an S Corporation LLC LLP or Partnership enter name and FEIN of the entity CU Partner full name died during 2013 DUE DATE: April 15 2014 Please PRINT in BLUE or BLACK INK DEPT USE ONLY Earned in 2013 Earned income tax credit from Federal Form 1040 Line 64a; EIC worksheet and Schedule IN 113 ELIGIBILITY QUESTIONS MUST BE ANSWERED Enter amount from Line 22 Enter figures in Column A from your federal Enter Spouse or entity FEIN: Estimated Tax (Worksheet IN 152 or 152A) EXEMPTIONS CLAIMED (Federal Form 1040 Line 6d; 1040A Line 6d; 1040EZ/1040NR EZ enter 0 1 or 2) 9 Federal Return information FEDERAL TAXABLE INCOME (Federal Form 1040 Line 43; 1040A Line 27; Filing Filing Enter Spouse or CU Partner FILING STATUS Firm s name (or yours if self employed) and address EIN First Name First Name For amended For FULL YEAR residents and PART YEAR residents For VT Portion enter income earned while Form 5329) HSA (Form 8889) and MSA (Form 8853) 1 Form IN 111 Form IN 111 Line 24 6 Form IN 111 page 2 of 2 FULL YEAR RESIDENTS: Answer eligibility questions above and complete Lines 1 and 2 Household Filing Filing Widow(er) with If credits from more than one business entity fill out a separate Schedule IN 112 Part IV for each entity If negative If you answered No and do not have any qualifying children you do not qualify for Earned Income Tax Credit IN 111 IN 112 IN 113 Column B Lines 1 6 10 & 12 INCOME ADJUSTMENT (Schedule IN 113 Line 43 OR 100 00%) 21 INCOME FROM NON VT STATE AND LOCAL OBLIGATIONS TO BE ADDED TO VT TAXABLE INCOME Subtract Line 2 from Line 1 but not less than zero ENTER ON FORM IN 111 LINE 12a 3 Income Tax Return 2013 indicate Initial Initial Interest and Penalty on Underpayment of Jointly Jointly dependent children Keep a copy for your records Lines 6 10 & 12) loss 4 Mailing Address (Number and Street/Road or PO Box) Member or Shareholder (see page 9) 31f Multiply Line 4 by 24% 5 Name of Nongame Wildlife Fund Children s Trust Fund VT Veterans Fund Original refund received Refund due now Original payment Amount due now PART I ADJUSTMENT TO TAXABLE INCOME PART II ADJUSTMENTS TO VT INCOME TAX PART III VT EARNED INCOME TAX CREDIT PART IV VT INCOME TAX CREDITS PART YEAR RESIDENTS: Answer eligibility questions above and complete Lines 3 9 Payments and Credits Please PRINT in BLUE or BLACK INK ATTACH TO FORM IN 111 Preparer s Preparer s signature Date Preparer s Preparer s Telephone Number Qualified Sale of Mobile Home Park Recapture of Federal Investment Tax Credit Recapture of VT Credits (See instructions) 6 Refund Research & Development (32 V S A 5930ii) 4 returns only SCHEDULE Schedule IN 112 Schedule IN 112 19 Schedule IN 112 page 2 of 2 *131121200* See instructions on page 11 1 Separately Separately Social Security Number Signature Date Occupation Telephone Number Signature If a joint return BOTH must sign Date Occupation Signatures Spouse or CU Partner Social Security Number SSN or Staple W 2/1099s here State STATE OR CANADIAN PROVINCE Part IV Line 6 OR Schedule IN 119) (Add Lines 23 and 24) SUBTRACTIONS FROM VT TAX: SUBTRACTIONS: Tax Filing Information2 Tax from Federal Form 4972 Line 7 or 30 3 Tax on Qualified Plans including IRA (1040 Line 58 or Taxable Income Taxpayer InformationSpouse or CU Partner Last Name Taxpayer s Last Name Taxpayer s Social Security Number TIMES (x) 10 = Total interest and dividend income from all state and local obligations exempt from federal tax Under penalties of perjury I declare that I have examined this return and accompanying schedules and statements and to the best of my knowledge Use Only VERMONT Veteran Business Credit (32 V S A 5930nn) 5 VT Department of Taxes PO Box 1779 Montpelier VT 05601 1779 VT Department of Taxes PO Box 1881 Montpelier VT 05601 1881 VT Higher Education Investment (32 V S A 5825a) VT Income Tax VT INCOME TAX FROM VT TAX TABLE OR TAX RATE SCHEDULE on Line 15 amount 16 VT Tax Adjustments VT TAXABLE INCOME With payment mail to: ZIP Code