Form In-113 - Income Adjustment Schedules - 2005
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1
2*051131199*
2005
FORM
Income Adjustment Schedules
IN-113
VERMONT
* 0 5 1 1 3 1 1 9 9 *
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 in Column A and list the VT portion in Column B. See instructions.
B. VT Portion $
A. Federal Amount $
.
.
,
,
,
,
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.
.
.
,
,
,
,
0 0
0 0
4. Taxable refunds of state and local income taxes . . . . . . 4.
4.
.
.
,
,
,
,
0 0
0 0
5. Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.
5.
Check to
Check to
.
.
,
,
,
,
indicate loss
indicate loss
0 0
0 0
6. Business income or loss . . . . . . . . . .
6.
6.
Check to
Check to
indicate loss
.
indicate loss
.
,
,
,
,
0 0
0 0
7. Capital gain or loss. . . . . . . . . . . . . . .
7.
7.
.
.
,
,
,
,
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
.
.
indicate loss
,
indicate loss
,
,
,
0 0
0 0
10. Partnerships/S Corporations & LLCs
10.
10.
Check to
Check to
.
.
indicate loss
,
,
indicate loss
,
,
0 0
0 0
11. Rents, royalties, estates, trusts, etc.
11.
11.
Check to
Check to
.
.
,
,
,
,
indicate loss
indicate loss
0 0
0 0
12. Farm income or loss. . . . . . . . . . . . . .
12.
12.
.
.
,
,
,
,
0 0
0 0
13. Unemployment compensation . . . . . . . . . . . . . . . . . . . . 13.
13.
.
.
,
,
,
,
0 0
0 0
14. Taxable social security . . . . . . . . . . . . . . . . . . . . . . . . . . 14.
14.
Check to
Check to
indicate loss
.
indicate loss
.
,
,
,
,
0 0
0 0
15. Other: Specify______________
15.
15.
11
(See instructions on page
)
Check to
Check to
.
.
indicate loss
,
indicate loss
,
,
,
0 0
0 0
16. TOTAL INCOME (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 federal tax return and these adjustment schedules to your Vermont return.
continued on back
21
Form IN-113
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