Form Fi-161 - Vermont Fiduciary Return Of Income - 2014 Page 4

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Name of Estate or Trust
Employer Identification Number
SCHEDULE E. INCOME ADJUSTMENT CALCULATION
Nonresidents and Part-Year Residents must complete this section
INCOME
A. Federal Amount $
B. VT Portion $
51. Interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51.
52. Total ordinary dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52.
53. Business income or (loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53.
54. Capital gain (or loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54.
55. Rents, royalties, partnerships, S Corporations, LLCs, other estates
and trusts, etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55.
56. Farm income (or loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56.
57. Ordinary gain (or loss) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57.
58. Other income (specify type of income) _______________________ . . . . . 58.
59. Total income (add Lines 51 through 58) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59.
60. Non-VT income (Column A, Line 59 less Column B, Line 59).
Enter here and on Schedule C, Line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60.
Dates of VT residency in 2014: From: ________________________to: _______________________
Name of state(s), Canadian province or country during non-VT residency:
Form FI-161
Page 4 of 4
Rev. 01/15

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