1. *071131199*
Income Adjustment FORM
2007
IN-113
Schedules
VERMONT
*071131199*
Nonresidents and Part-Year Residents Must Complete Schedules I and II
Full-Year Residents with Adjustments Complete Schedule II only
ATTACH TO FORM IN-111
PRINT in BLUE or BLACK INK
Taxpayer’s Social Security Number
- -
Taxpayer’s Last Name First Name Initial
SCHEDULE I. Enter figures as they appear on your federal return or recomputed federal return in Column A and list the VT portion in Column B.
See instructions on page 12.
B. VT Portion $
A. Federal Amount $
. 00 . 00
, ,
, ,
1. Wages, salaries, tips, etc. . . . . . . . . . . . . . . . . . . . . . . 1. 1.
. 00 . 00
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2. Taxable interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. 2.
. 00 . 00
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3. Ordinary dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. 3.
. 00 . 00
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, ,
4. Taxable refunds of state and local income taxes . . . 4. 4.
. 00 . 00
, ,
, ,
5. Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. 5.
Check to Check to
. 00 . 00
, ,
, ,
indicate loss indicate loss
6. Business income or loss . . . . . . . 6. 6.
Check to
Check to
. 00 . 00
indicate loss
indicate loss
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, ,
7. Capital gain or loss . . . . . . . . . . . 7. 7.
. 00 . 00
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8. Taxable IRA distributions. . . . . . . . . . . . . . . . . . . . . . . 8. 8.
INCOME
. 00 . 00
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, ,
9. Taxable pensions and annuities . . . . . . . . . . . . . . . . . 9. 9.
Check to Check to
10. Partnerships/S Corporations,
. 00 . 00
indicate loss indicate loss
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, ,
and LLCs . . . . . . . . . . . . . . . . . . . . 10. 10.
Check to Check to
11. Rents, royalties, estates,
. 00 . 00
indicate loss indicate loss
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, ,
trusts, etc.. . . . . . . . . . . . . . . . . . . 11. 11.
Check to Check to
. 00 . 00
, ,
, ,
indicate loss indicate loss
12. Farm income or loss. . . . . . . . . . . 12. 12.
. 00 . 00
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13. Unemployment compensation . . . . . . . . . . . . . . . . . 13. 13.
. 00 . 00
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14. Taxable social security . . . . . . . . . . . . . . . . . . . . . . . 14. 14.
Check to Check to
indicate loss indicate loss
. 00 . 00
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15. Other: Specify____________ 15. 15.
(See instructions on page 12)
Check to
Check to
16. TOTAL INCOME
. 00 . 00
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, ,
indicate loss
indicate loss
(Add Lines 1–15) . . . . . . . . . . . . . 16. 16.
Be sure to put your name and Social Security number at the top of this page.
Attach copies of pages 1 and 2 of your filed or recomputed federal tax return and this schedule to your VT return.
continued on back 23
Form IN-113

2. *071131299*
Form IN-113, page 2
*071131299*
Carried forward from __________________________________ _______________________________
Line 16A Line 16B
A. Federal Amount $ B. VT Portion $
17. IRA (1040-Line 32; or 1040A-Line 17); Keogh/SEP/SIMPLE (1040-Line 28):
. 00 . 00
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Self ______________17.Spouse ______________ . . . . . . 17. 17.
18. Education Deductions: Educator expenses (1040-Line 23;
. 00
. 00 ,
1040A-Line 16); Student Loan Interest (1040-Line 33; 1040A-Line 18);
,
,
,
Tuition fees (1040-Line 34; 1040A-Line 19). . . . . . . . . . . . . . . . . . . . . . . . 18. 18.
. 00 . 00
19. Employee Deductions: Reservists, Performing Artists, Fee-basis
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Gov’t Officials (1040-Line 24) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 19.
20. Self-Employment Deductions: Tax (1040-Line 27), and Health
. 00 . 00
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Insurance (1040-Line 29) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. 20.
. 00 . 00
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ADJUSTMENTS TO INCOME
21. Health Savings Account (1040-Line 25) . . . . . . . . . . . . . . . . . . . . . . . . . . . 21. 21.
. 00 . 00
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22. Moving Expenses (1040-Line 26) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22. 22.
. 00 . 00
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23. Penalty on Early Withdrawal of Savings (1040-Line 30) . . . . . . . . . . . . . . . 23. 23.
. 00 . 00
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24. Alimony Paid (1040-Line 31a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24. 24.
. 00 . 00
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25. Domestic Production Activities (1040-Line 35). . . . . . . . . . . . . . . . . . . . . 25. 25.
. 00 . 00
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26. Deductions not listed above but included on 1040-Line 36 . . . . . . . . . . . 26. 26.
. 00 . 00
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27. TOTAL ADJUSTMENTS (Add Lines 17 – 26) . . . . . . . . . . . . . . . . . . . . . 27. 27.
Check to indicate
. 00
,
,
loss
28. Adjusted Gross Income (Subtract Line 27A from Line 16A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.
Check to indicate
. 00
,
,
loss
29. VT Portion of AGI (Subtract Line 27B from Line 16B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.
Check to indicate
. 00
,
,
loss
30. Non-VT Income (Subtract Line 29 from Line 28. Enter result here and on Schedule II, Line 32 below). . 30.
Dates of VT residency in 2007: From ____________ to ____________ Name of state(s), Canadian province or country during non-VT residency: __________________
SCHEDULE II. Adjustment for VT Exempt Income
Check to indicate
31. Adjusted Gross Income If Schedule I completed, enter Line 28.
. 00
,
,
loss
Otherwise, enter amount from Form IN-111, Section 2, Line 10. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.
Check to indicate
. 00
,
, (Full-year VT residents enter 0 on Line 32)
loss
32. Non-VT Income . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.
(Enter amount from Line 30 above)
Part-Year Residents: For Lines 33-39
Enter only income included in Schedule I, Line 29
. 00
,
,
33. Military pay. Number of months on active duty____ (See instructions) . 33.
. 00
,
,
VT EXEMPT INCOME
34. Federal Employment Opportunity income adjustment . . . . . . . . . . . . . . . 34.
. 00
,
,
35. Railroad Retirement income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35.
. 00
36. VT State payments to a family for support of developmentally
,
,
disabled person(s) (See instructions on page 44) . . . . . . . . . . . . . . . . . . 36.
. 00
,
,
37. Americans with Disabilities Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.
. 00
,
,
38. Nonresident Commercial Film Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38.
. 00
,
,
39. VT Telecommunication Authority bond/note interest . . . . . . . . . . . . . . . 39.
Check to indicate
. 00
,
,
loss
40. Total (Add Lines 32-39) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40.
Check to indicate
. 00
,
,
loss
41. VT income (Subtract Line 40 from Line 31). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.
. %
42. INCOME ADJUSTMENT % (Divide Line 41 by Line 31) Enter here and on Form IN-111, Section 4, Line 21. See instructions. . . . . . . . . . . . . . . . . $ 42.
Form IN-113
24