Form In-113 - Income Adjustment Schedules - 2000 Page 2
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2Carried forward from
_________________________________
_________________________________
Line 16A
Line 16B
A. Federal Amount $
B. Vermont Portion $
17. IRA/Keogh/SEP/SIMPLE:
Self__________________________________________00.
Spouse ________________________________________17.
17.
18. Student Loan Interest Deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.
18.
19. Medical Savings Account Deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.
19.
20. Deduction for Self-Employment Tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.
20.
21. Self-Employment Health Insurance Deduction . . . . . . . . . . . . . . . . . . . . . . . . 21.
21.
22. Moving Expenses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.
22.
23. Penalty on Early Withdrawal of Savings. . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.
23.
24. Alimony Paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.
24.
25. TOTAL ADJUSTMENTS (Add Lines 17 – 24) . . . . . . . . . . . . . . . . . . . . . 25.
25.
26. Adjusted Gross Income (Subtract Line 25A from Line 16A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.
27. Vermont Portion of AGI (Subtract Line 25B from Line 16B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.
28. Non-Vermont Income (Subtract Line 27 from Line 26. Enter result here and on Schedule II, Line 30 below) . . . . . . . . . . . . . . . . . 28.
Dates of VERMONT residency in
2000:
From ________________________________________ to ________________________________________
Name of resident state(s) during period of nonresidency in Vermont:________________________________________
SCHEDULE II. Adjustment for Vermont Exempt Income
29. Adjusted Gross Income (Federal amount or recomputed amount, if applicable). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.
30. Non-Vermont Income (Enter amount from Line 28 above) . . . . . . . . . . . . 30.
(Full-year Vermont residents enter 0 on Line 30)
(Part-Year Residents: For Lines 31-39, enter only income included in Line 27, Schedule I – See instructions)
31. Interest on U.S. Government obligation: (Attach statements). . . . . . . . . . 31.
32. Military pay. Number of months on active duty____ (See Instructions) . 32.
33. Lottery prizes from Vermont state-run lottery . . . . . . . . . . . . . . . . . . . . . . 33.
34. Targeted Jobs Credit income adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . 34.
35. Railroad Retirement income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35.
36. VT State payments for support of developmentally disabled person(s) . . 36.
37. Americans with Disabilities Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.
38. Non-resident Commercial Film Income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38.
39. Vermont Higher Education Savings Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . 39.
40. Total (Add Lines 30-39) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40.
41. Vermont income (Subtract Line 40 from Line 29) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.
%
42. INCOME ADJUSTMENT % (Divide Line 41 by Line 29) Enter here and on Form IN-111, Section 3, Line 3. See instructions . . . . . . . . . . . . . . . . . . . . . 42.
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Form IN-113
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