Form Pt-172-B - Property Transfer Tax Return Page 2

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Buyer #1 or Entity _____________________________________________________
*151721800*
SSN or FID ___________________________________________________________
Property Location _____________________________________________________
Date of Closing _______________________________________________________
* 1 5 1 7 2 1 8 0 0 *
Attachment for
Additional
VERMONT
BUYERS
(cont.)
Property Transfer Tax Return
BUYER #7
BLACK OUT ALL ID NUMBERS BELOW ON TOWN COPY ONLY
Individual BUYER #7 Last Name
First Name
Initial
Individual BUYER #7 Social Security Number
For Department Use Only
BUYER #7 Mailing Address Following Transfer
City
State
ZIP Code
Foreign Country (if not United States)
BUYER #8
Individual BUYER #8 Last Name
First Name
Initial
Individual BUYER #8 Social Security Number
For Department Use Only
BUYER #8 Mailing Address Following Transfer
City
State
ZIP Code
Foreign Country (if not United States)
BUYER #9
Individual BUYER #9 Last Name
First Name
Initial
Individual BUYER #9 Social Security Number
For Department Use Only
BUYER #9 Mailing Address Following Transfer
City
State
ZIP Code
Foreign Country (if not United States)
BUYER #10
Individual BUYER #10 Last Name
First Name
Initial
Individual BUYER #10 Social Security Number
For Department Use Only
BUYER #10 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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