Form In-113 - Income Adjustment Schedules - Vermont Department Of Taxes - 1998 Page 3

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Carried forward from

Line 16A

Line 16B

B. Vermont Portion $

A. Federal Amount $

______________________

17. IRA/Keogh: Self

_________________________

17.

Spouse

18. Deduction for self-employment tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18.

19. Self-employed health insurance deduction . . . . . . . . . . . . . . . . . . . . . .

19.

20. Moving expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

20.

21. Alimony paid and penalty on early withdrawal of savings . . . . . . . . . . .

21.

22. TOTAL ADJUSTMENTS (Add Lines 17-21) . . . . . . . . . . . . . . . . . . . .

22.

23. Adjusted gross income (Subtract Line 22A from Line 16A). . . . . . . . . . .

23.

24.

24. Vermont portion of AGI (Subtract Line 22B from Line 16B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

25.

25. NON-VERMONT INCOME (Subtract Line 24 from Line 23) Enter here and on Schedule II, Line 27 below . . . . . . . . . . . . . . . . .

Dates of VERMONT residency in 1998: From __________________________________________________to _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Name of resident state(s) during period of nonresidency in Vermont:

SCHEDULE II. Income Adjustment

26. Adjusted Gross Income (Federal amount or recomputed amount, if applicable) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

26.

27.

27. Non-Vermont income (Enter amount from Line 25 above) . . . . . . . . . . . . . . . . . . .

(Part-Year Residents: For Lines 28-35, enter only income included in Line 24, Schedule I – See instructions)

28. Interest on U.S. Government obligation:

28.

(Attach statements). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

29. Military pay. Number of months on active duty

. . . . . . . . . . . . . . .

29.

_____________

30.

30. Lottery prizes from Vermont state-run lottery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

31. Targeted Jobs Credit income adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

31.

32. Railroad retirement income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

32.

33. VT State payments for support of developmentally disabled person(s) . . . . . . . .

33.

34. Americans with Disabilities Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

34.

35.

35. Non-resident Commercial Film Income. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36. Total (Add Lines 27-35) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36.

37. Vermont income (Subtract Line 36 from Line 26) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

37.

38. INCOME ADJUSTMENT % (Divide Line 37 by Line 26) Enter here and on Form IN-111, Section 3, Line 3.

See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

38.

Form IN-113