Form In-111 - Vermont Income Tax Return - 2013
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4DUE DATE: April 15, 2014
Please PRINT in BLUE or BLACK INK
*131111100*
DEPT USE ONLY
2013
FORM
Income Tax Return
111
IN-
* 1 3 1 1 1 1 1 0 0 *
VERMONT
1
Taxpayer’s Last Name
First Name
Initial
Taxpayer’s Social Security Number
Spouse or CU Partner Last Name
First Name
Initial
Spouse or CU Partner Social Security Number
Mailing Address (Number and Street/Road or PO Box)
City
State
ZIP Code
Check here if using RECOMPUTED
Federal Return information
Check here if this is
Check if taxpayer
Check if Spouse or CU Partner
an AMENDED return
died during 2013
died during 2013
1. VT School Code
2. 911 street address on 12/31/2013 - Number, street/road name (Do not use “PO Box”, “same”, or Town name)
2
FILING STATUS
Enter Spouse or
c
c
c
c
c
c
c
CU Partner full name ________________________________
8a. Married
8b. CU
3. Single
4. Head of
5. Married
6. CU Partner
7. Qualifying
Filing
Filing
Enter Spouse or CU Partner
Household
Filing
Filing
Widow(er) with
Separately
Separately
Social Security Number _______________________________
Jointly
Jointly
dependent children
9.
EXEMPTIONS CLAIMED (Federal Form 1040–Line 6d; 1040A–Line 6d; 1040EZ/1040NR-EZ–enter 0, 1, or 2) . . . . . . . . . . . . . . . . . . . . . . . . . 9. ______
3
Check to
ç indicate
.0 0
loss
10. ADJUSTED GROSS INCOME (Federal Form 1040–Line 37; 1040A–Line 21; 1040EZ–Line 4)
10. _____________________________________
Check to
11. FEDERAL TAXABLE INCOME (Federal Form 1040–Line 43; 1040A–Line 27;
ç indicate
.0 0
loss
1040EZ–Line 6) If the Federal amount is zero, see instructions on page 6 . . . . . . . . . . . . . .
11. _____________________________________
ADDITIONS:
.0 0
12a. Income from Non-VT State and Local Obligations (Schedule IN-112, Part I, Line 3) . . . . . . . . . . . . . . . . 12a. _____________________________________
.0 0
12b. Bonus Depreciation allowed under Federal law for 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12b. _____________________________________
If negative
ç check
.0 0
12c. Addback of State and Local Income Taxes (Schedule IN-154, Line 10) . . . . . . . . . . . . . .
12c. _____________________________________
here
Check to
ç indicate
.0 0
loss
13. FEDERAL TAXABLE INCOME WITH ADDITIONS (Add Lines 11, 12a, 12b, and 12c) . . .
13. _____________________________________
SUBTRACTIONS:
.0 0
14a. Interest Income from U.S. Obligations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14a. _____________________________________
.0 0
14b. Capital Gains Exclusion (Schedule IN-153, Line 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14b. _____________________________________
.0 0
14c. Adjustment for prior years’ Bonus Depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14c. _____________________________________
.0 0
14d . Add Lines 14a, 14b, and 14c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14d. _____________________________________
15. VT TAXABLE INCOME
.0 0
(Subtract Line 14d from Line 13 . If Line 14d is more than Line 13, enter zero .) . . . . . . . . . . . . . . . . . . . . . 15. _____________________________________
4
.0 0
16. VT INCOME TAX FROM VT TAX TABLE OR TAX RATE SCHEDULE on Line 15 amount . . . . . 16. _____________________________________
.0 0
17. ADDITIONS TO VT INCOME TAX (Schedule IN-112, Part II, Line 7) . . . . . . . . . . . . . . . . . . . . . . . . . . 17. _____________________________________
.0 0
18. VT INCOME TAX WITH ADDITIONS (Add Lines 16 & 17) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. _____________________________________
.0 0
19. SUBTRACTIONS FROM VT INCOME TAX (Schedule IN-112, Part II, Line 15) . . . . . . . . . . . . . . . . . 19. _____________________________________
.0 0
20. VT INCOME TAX (Subtract Line 19 from Line 18 . If Line 19 is more than Line 18, enter zero) . . . . . . . 20. _____________________________________
%
.
21. INCOME ADJUSTMENT (Schedule IN-113, Line 43 OR 100 .00%) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. _____________________
.0 0
22. ADJUSTED VT INCOME TAX (Multiply Line 20 by Line 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. _____________________________________
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Continued on back
*
Form IN-111
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