Schedule In-113 - Income Adjustment Calculations - 2017
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1
2*171131100*
Income Adjustment
2017
SCHEDULE
113
IN-
Calculations
VERMONT
* 1 7 1 1 3 1 1 0 0 *
Nonresidents and Part-Year Residents Must Complete Parts I and II
Full-Year Residents with Adjustments Complete only Part II
Please PRINT in BLUE or BLACK INK
INCLUDE WITH FORM IN-111
Taxpayer’s Last Name
First Name
Initial
Taxpayer’s Social Security Number
PART I. Enter figures as they appear on your federal return or recomputed federal return in Column A and list the Vermont portion in
Column B. See instructions.
Dates of Vermont residency in 2017
Name of state(s), Canadian province or
country during non-Vermont residency
From (MM DD YYYY)
To (MM DD YYYY)
(use standard 2-character abbreviation)
A. Federal Amount $
B. Vermont Portion $
.0 0
.0 0
1. Wages, salaries, tips, etc. . . . . . . . . . . . . . . . . . . .1.__________________________________
1.__________________________________
.0 0
.0 0
2. Taxable interest . . . . . . . . . . . . . . . . . . . . . . . . . . .2.__________________________________
2.__________________________________
.0 0
.0 0
3. Ordinary dividends . . . . . . . . . . . . . . . . . . . . . . . .3.__________________________________
3.__________________________________
4. Taxable refunds of state and local
.0 0
.0 0
income taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4.__________________________________
4.__________________________________
.0 0
.0 0
5. Alimony received . . . . . . . . . . . . . . . . . . . . . . . . .5.__________________________________
5.__________________________________
Check to
Check to
.0 0
.0 0
ç indicate
ç indicate
6. Business income or loss . . . . . .
6.__________________________________
6.__________________________________
loss
loss
Check to
Check to
.0 0
.0 0
ç indicate
ç indicate
7. Capital gain or loss . . . . . . . . . .
7. _________________________________
7.__________________________________
loss
loss
.0 0
.0 0
8. Taxable IRA distributions . . . . . . . . . . . . . . . . . .8.__________________________________
8.__________________________________
.0 0
.0 0
9. Taxable pensions and annuities . . . . . . . . . . . . . .9.__________________________________
9.__________________________________
Check to
Check to
10. Partnerships/ S Corporations,
.0 0
.0 0
ç indicate
ç indicate
and LLCs . . . . . . . . . . . . . . . . .
10.__________________________________
10.__________________________________
loss
loss
Check to
Check to
11. Rents, royalties, estates,
.0 0
.0 0
ç indicate
ç indicate
11.__________________________________
11.__________________________________
trusts, etc. . . . . . . . . . . . . . . . . .
loss
loss
Check to
Check to
.0 0
.0 0
ç indicate
ç indicate
12. Farm income or loss . . . . . . . . .
12. _________________________________
12.__________________________________
loss
loss
.0 0
.0 0
13. Unemployment compensation . . . . . . . . . . . . . .13.__________________________________
13.__________________________________
.0 0
.0 0
14. Taxable Social Security . . . . . . . . . . . . . . . . . . .14.__________________________________
14.__________________________________
Check to
Check to
.0 0
.0 0
ç indicate
ç indicate
15. Other: Specify____________ . .
15.__________________________________
15.__________________________________
loss
loss
(See instructions)
Check to
Check to
16. TOTAL INCOME
.0 0
.0 0
ç indicate
ç indicate
(Add Lines 1–15) . . . . . . . . . . .
16.__________________________________
16.__________________________________
loss
loss
continued on back
5454
23
Schedule IN-113
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