Schedule Ba-410 - Vermont Corporate Income Tax Affiliation Schedule

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VT DEPARTMENT OF TAXES, 133 State Street, Montpelier, VT 05633-1401 / (802) 828-5723
*124101100*
Corporate Income Tax
SCHEDULE
VERMONT
Affiliation Schedule
BA-410
* 1 2 4 1 0 1 1 0 0 *
REQUIRED FOR COMBINED AND CONSOLIDATED RETURNS.
Check here if any address below is an INTERNATIONAL address
Federal ID Number
Name of Principal Vermont Corporation
Affiliate’s group type (Check ONE)
Federal ID Number
Water’s Edge
Excluded from VT Water’s
Excluded Qualified
Vermont
Check if
Combined
Edge Combined Group as
Overseas Business
Consolidated
Nexus
Group Member
nonunitary member
Organization
Group
in VT
Affiliate Name
Mailing Address, Line 1
Mailing Address, Line 2
City or Town
State
Zip Code
-
Affiliate’s group type (Check ONE)
Federal ID Number
Water’s Edge
Excluded from VT Water’s
Excluded Qualified
Vermont
Check if
Combined
Edge Combined Group as
Overseas Business
Consolidated
Nexus
Group Member
nonunitary member
Organization
Group
in VT
Affiliate Name
Mailing Address, Line 1
Mailing Address, Line 2
City or Town
State
Zip Code
-
Affiliate’s group type (Check ONE)
Federal ID Number
Water’s Edge
Excluded from VT Water’s
Excluded Qualified
Vermont
Check if
Combined
Edge Combined Group as
Overseas Business
Consolidated
Nexus
Group Member
nonunitary member
Organization
Group
in VT
Affiliate Name
Mailing Address, Line 1
Mailing Address, Line 2
City or Town
State
Zip Code
-
Schedule BA-410
Continue on back, if necessary
Rev. 10/12

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