Form Bi-471 - Vermont Business Income Tax Return Page 2

*124711200*

* 1 2 4 7 1 1 2 0 0 *

Enter all amounts in whole dollars.

SCHEDULE 1: TAX PAYMENTS and CREDITS COMPUTATIONS

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9. Prior Year Overpayment Applied . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9.

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10. Estimated Payments and Payments with Extension . . . . . . . . . . . . . . . . . . .10.

(Use these lines only if a composite filer .)

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11. NONRESIDENT REAL ESTATE WITHHOLDING (Form RW-171) . . . . 11.

12. NONRESIDENT (Form WH-435) payments made for this entity

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by another entity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12.

13. TAX CREDITS (Form BA-404, Column C, Line 15) .

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Attach required documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.

NOTE: Line 13 Tax Credits may not reduce your tax liability to less than the minimum tax or by an amount more than 80% of the original / pre-credit

tax liability, depending on the source of the credits.

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14. Add Lines 9 and 10, and if a composite filer, Lines 11, 12, and 13 . . . . . . . .14.

15. For Composite entities only: Total estimated tax payments made with

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Form WH-435 on behalf of nonresidents consenting to the composite filing . 15.

16. TOTAL PAYMENTS and CREDITS (Add Lines 14 and 15)

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(Enter total here and on Side 1, Line 6 .) . . . . . . . . . . . . . . . . . . . . . . . . . . . .16.

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17. Total payments made with Form WH-435 . . . . . . . . . . . . . . . . . . . . . . . . . .17.

I. Total number of Shareholders, Partners, or Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I.

J. How many are VT residents? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J.

K. How many are nonresidents? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .K.



L. Check box if §5920(f) or (g) applies . Attach authorization or documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L.

I hereby certify that I am an officer or authorized agent responsible for the taxpayer’s compliance with the requirements of Title 32 of the Vermont Statutes and that this

return is true, correct and complete to the best of my knowledge. If prepared by a person other than the taxpayer, this declaration further provides that under 32 V.S.A.

§5901, this information has not been and will not be used for any other purpose, or made available to any other person, other than for the preparation of this return

unless a separate valid consent form is signed by the taxpayer and retained by the preparer.

Signature of Officer or Authorized Agent

Printed name

Date

Daytime telephone

May the Dept. of Taxes discuss this

number (optional)

return with the preparer shown?

(

)

 Yes

 No

Preparer’s

Date



Check if self-employed

signature

Paid

Preparer’s

Preparer’s Social

Security No. or PTIN

Preparer’s

printed name

Use Only

EIN

Firm’s name (or yours

if self-employed) and

address

Preparer’s Telephone Number

Form BI-471

5432

Rev. 01/13