Form Pt-172-B - Property Transfer Tax Return

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Buyer #1 or Entity _____________________________________________________
*151721700*
SSN or FID ___________________________________________________________
Property Location _____________________________________________________
Date of Closing _______________________________________________________
* 1 5 1 7 2 1 7 0 0 *
Form
Attachment for
Additional
VERMONT
BUYERS
PT-172-B
(Use Form PT-172-S to list
Property Transfer Tax Return
additional SELLERS)
BUYER #3
BLACK OUT ALL ID NUMBERS BELOW ON TOWN COPY ONLY
Entity BUYER #3 Name
Entity BUYER #3 Federal ID Number
Individual BUYER #3 Last Name
First Name
Initial
Individual BUYER #3 Social Security Number
BUYER #3 Mailing Address Following Transfer
For Department Use Only
City
State
ZIP Code
Foreign Country (if not United States)
BUYER #4
Entity BUYER #4 Name
Entity BUYER #4 Federal ID Number
Individual BUYER #4 Last Name
First Name
Initial
Individual BUYER #4 Social Security Number
BUYER #4 Mailing Address Following Transfer
For Department Use Only
City
State
ZIP Code
Foreign Country (if not United States)
BUYER #5
Entity BUYER #5 Name
Entity BUYER #5 Federal ID Number
Individual BUYER #5 Last Name
First Name
Initial
Individual BUYER #5 Social Security Number
BUYER #5 Mailing Address Following Transfer
For Department Use Only
City
State
ZIP Code
Foreign Country (if not United States)
BUYER #6
Individual BUYER #6 Last Name
First Name
Initial
Individual BUYER #6 Social Security Number
For Department Use Only
BUYER #6 Mailing Address Following Transfer
City
State
ZIP Code
Foreign Country (if not United States)
Form PT-172-B,
Additional BUYERS
For Town Use Only
(Attach to Form PT-172)
Rev. 06/15
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