Form K-1VT Fillable Shareholder's, Partner's, or Member's Information
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

Nonresident YES NO (Enter on Form IN 111 Section 7 Line 31f) (Do NOT enter on Line 31a!) 5 (Enter on IN 111 Line 12b or Line 14c) * 1 2 K 1 V 1 1 0 0 * *12K1V1100* 1 Share of Vermont Net Income (Loss) 133 State Street Montpelier VT 05633 1401 / (802) 828 5723 2 Guaranteed Payments (Partnership and LLC only) 2 3 VT K 1 income (Add Lines 1 and 2) 4 Real Estate Withholding (REW) (From Form RW 171 5 Nonresident Estimated Payments (From Form WH 435) 6a Payroll Tax Credit (32 V S A 5930c) 6a 6b Research & Development Tax Credit (32 V S A 5930d) 6b 6c Capital Investment Tax Credit (32 V S A 5930g) 6c 6d Export Tax Credit (32 V S A 5930f) 6d 6e Other EATI credits 6e 6f Historic Rehabilitation (32 V S A 5930n 5930p and 5930cc(a) and 6g Facade Improvement Tax Credits (32 V S A 5930q and 5930cc(b)) 6g 6h Code Improvements Tax Credits (32 V S A 5930r and 5930cc(c)) 6h 6i Affordable Housing (32 V S A 5930u) 6i 6j Business Solar Tax Credit (32 V S A 5822(d) and 5930z) 6j 6k Other credits not listed above 6k 7 Credit Total (Add Lines 6a through 6k) 7 9 Share of VT apportioned federal bonus depreciation difference address Attach to Form BI 471 Business Name Check here City State ZIP Code Enter all amounts in whole dollars Enter I C S Exempt Federal ID Number Filing with Entity s composite Flood Recovery ( 5930bb(d)) Tax Credits 6f For the taxable period beginning 20 and ending 20 HEADER INFORMATION REQUIRED ENTRIES if this is an Individual Last Name (Shareholder Partner or Member) First Name Initial instructions) INTERNATIONAL K 1VT L P or T (see Mailing Address Line 1 Mailing Address Line 2 Month MonthShareholder Partner or Member Name of credit: NOTE: If Line 3 above is a positive number over $100 then you have a statutory individual (or corporate) filing requirement in Vermont OR Entity Name (Shareholder Partner or Member) or Member Information Percentage of Entity s income or lossto this recipient Calculate percentage to sixplaces to the right of the decimal point Recipient Type Residency status return? (See Form BI 471) Rev 10/12 REW Schedule A) (Enter on Form IN 111 Section 7 Line 31e) 4 SchEDUlE Schedule K 1VT Share of total federal bonus depreciation difference Social Security or Federal ID Number This form is REQUIRED Transcribe the amounts from Lines 4 and 5 if any to the Vermont Individual Income Tax Return VERMONT Shareholder Partner VT DEPARTMENT OF TAXES VT Resident / Your share of pass through credits: Transcribe these amounts to Schedules IN 112 or IN 119