Form In-113 - Income Adjustment Schedules - 2006 Page 2
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2*061131299*
Form IN-113, page 2
* 0 6 1 1 3 1 2 9 9 *
Carried forward from
__________________________________
_______________________________
Line 16A
Line 16B
17. IRA (1040-Line 32; or 1040A-Line 17); Keogh/SEP/SIMPLE (1040-Line 28):
A. Federal Amount $
B. VT Portion $
Self
__________________________________________17.
.
.
,
,
,
,
0 0
0 0
Spouse ________________________________________17.
17.
.
.
,
,
,
,
0 0
0 0
18. Student Loan Interest (1040-Line 33; 1040A-Line 18) . . . . . . . . . . . . . . . 18.
18.
19. Employee Deductions: Reservists, Performing Artists, Fee-basis
.
.
Gov’t Officials (1040, Line 24); Jury Duty Pay (1040, Line 34;
,
,
,
,
0 0
0 0
1040A, Line 19) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
19.
.
.
,
,
20. Self-Employment Deductions: Tax (1040, Line 27), and Health
,
,
0 0
0 0
Insurance (1040, Line 29) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.
20.
.
.
21. Health Savings Account (1040, Line 25) and
,
,
,
,
0 0
0 0
Archer MSA (1040, Line 23) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.
21.
.
.
,
,
,
,
0 0
0 0
22. Moving Expenses (1040, Line 26). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.
22.
.
.
,
,
,
,
0 0
0 0
23. Penalty on Early Withdrawal of Savings (1040-Line 30; 1040A-Line 16) . 23.
23.
.
.
,
,
,
,
0 0
0 0
24. Alimony Paid (1040, Line 31a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.
24.
.
.
,
,
,
,
0 0
0 0
25. Domestic Production Activities (1040, Line 35) . . . . . . . . . . . . . . . . . . . . 25.
25.
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.
,
,
,
,
0 0
0 0
26. TOTAL ADJUSTMENTS (Add Lines 17 – 25) . . . . . . . . . . . . . . . . . . . . . 26.
26.
Check to indicate
.
,
,
0 0
loss
27. Adjusted Gross Income (Subtract Line 26A from Line 16A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27.
Check to indicate
.
,
,
0 0
loss
28. VT Portion of AGI (Subtract Line 26B from Line 16B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
28.
Check to indicate
.
,
,
0 0
loss
29. Non-VT Income (Subtract Line 28 from Line 27. Enter result here and on Schedule II, Line 31 below) . .
29.
Dates of VT residency in 2006: From ____________________________ to ____________________________
Name of state(s), Canadian province, or country during non-VT residency: ________________________________________________
SCHEDULE II. Adjustment for VT Exempt Income
Check to indicate
30. Adjusted Gross Income If Schedule I completed, enter Line 27.
.
,
,
0 0
loss
Otherwise, enter Line 10 amount from IN-111 Section 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
30.
Check to indicate
.
,
,
0 0
(Full-year VT residents enter 0 on Line 31)
loss
31. Non-Vermont Income . . . . . . . . . . . . . . . . . . . . . .
31.
(Enter amount from Line 29 above)
(Part-Year Residents: For Lines 32-37, enter only income included in Line 28, Schedule I)
.
,
,
0 0
32. Military pay. Number of months on active duty____ (See instructions) . 32.
.
,
,
0 0
33. Federal Employment Opportunity income adjustment . . . . . . . . . . . . . . . 33.
.
,
,
0 0
34. Railroad Retirement income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34.
35. VT State payments to a family for support of developmentally
.
,
,
0 0
disabled person(s) (See instructions on page 44) . . . . . . . . . . . . . . . . . . 35.
.
,
,
0 0
36. Americans with Disabilities Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.
.
,
,
0 0
37. Nonresident Commercial Film Income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.
Check to indicate
.
,
,
0 0
loss
38. Total (Add Lines 31-37) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
38.
Check to indicate
.
,
,
0 0
39. VT income (Subtract Line 38 from Line 30) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
loss
39.
.
%
40. INCOME ADJUSTMENT % (Divide Line 39 by Line 30) Enter here and on Form IN-111, Section 4, Line 21. See instructions . . . . . . . . . . . . . . . $ $ 40.
Form IN-113
22
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