Schedule Ba-410 - Vermont Corporate Income Tax Affiliation Schedule

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Vermont Department of Taxes
133 State Street
Montpelier, VT 05633-1401
*144101100*
Phone: (802) 828-5723
CORPORATE INCOME TAX
VT Schedule
BA-410
AFFILIATION SCHEDULE
* 1 4 4 1 0 1 1 0 0 *
REQUIRED FOR COMBINED AND CONSOLIDATED RETURNS
Please provide information only for affiliates/subsidiaries with nexus in Vermont.
Name of Principal Vermont Corporation
Federal ID Number
Affiliate Name
Federal ID Number
Address
For Department Use Only
City
State
ZIP Code
Foreign Country (if not United States)
Affiliate Name
Federal ID Number
Address
For Department Use Only
City
State
ZIP Code
Foreign Country (if not United States)
Affiliate Name
Federal ID Number
Address
For Department Use Only
City
State
ZIP Code
Foreign Country (if not United States)
Affiliate Name
Federal ID Number
Address
For Department Use Only
City
State
ZIP Code
Foreign Country (if not United States)
Schedule BA-410
Continue on back, if necessary
Rev. 10/14

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