Enlarge image | Vermont Department of Taxes Form BI-471 *234711100* Vermont Business Income Tax Return *234711100* for Partnerships, Subchapter S Corporations, and LLCs Page 11 Check Name Composite Accounting Initial Public Law Pro Forma - X Change X Return X Period Change X Return X 86-272 Applies XCannabis Appropriate Box(es) Address Amended Extended Federal Final Return X Change X Return X Return X Extension Requested X(Cancels Account) Entity Name FEIN Primary 6-digit NAICS number 12345678901234567890123456789012(36) 123456789 123456 Address Tax year BEGIN date (YYYYMMDD) Tax year END date (YYYYMMDD) 12345678901234567890123456789012(36) 20230101 20231231 Address (Line 2) 12345678901234567890123456789012(36) Federal tax City State ZIP Code return filed 12345678901234567(21) 12 1234567890 (Check one X 1120S X 1065 X Other Foreign Country (if not United States) box) 1234567890123456789012345678(32) FORM (Place at FIRST page) A. Were any shareholders, partners, or members nonresidents of Vermont during this tax year? . . . . . . . . . .A. X Yes XNo Form pages B. Did this entity have income or losses derived from at least one state other than Vermont? . . . . . . . . . . . . B.. X Yes XNo If Yes, complete and attach Schedule BI-477 . C. Net adjustment to income resulting from Vermont’s disallowance of 123456789012345“bonus depreciation” (IRC 168(k)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .C. ________________________.00 11 - 12 D. 123456789012345Total number of Shareholders, Partners, or Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. ____________________________ E. 123456789012345How many are Vermont Residents? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E.. ____________________________ F. 123456789012345 How many are Nonresidents? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F.. ____________________________ G. Check box if 32 V .S .A . § 5920(f), (g), or (h) applies (regarding nonresident estimated payments for affordable housing projects, Xfederal new market tax credit projects, or publicly traded partnerships) . Attach authorization or documentation . . . . . . . . . . . . . . . . . . . .G. TAX COMPUTATION (see instructions): Enter all amounts in whole dollars. Check box if exception NO VERMONT ACTIVITY / INVESTMENT CLUB § 5921 IRC § 761 INACTIVE ($0) ($0) ($0) to minimum tax applies: X X X 1. 123Vermont minimum entity tax ($250) or above exception (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . 1.. ________________________.00 2. For non-composite entities 2a. Nonresident estimated payment requirement 123456789012345 (Schedule BI-472, Line 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2a. ________________________.00 2b. Overpayment distributed to owners (ADD Schedule K-1VT, Lines 11 and 12 from all schedules, then SUBTRACT 123456789012345 amount from Schedule BI-472, Line 6) . . . . . . . . . . . . . . . . . 2b. . ________________________.00 1234567890123452c. ADD Lines 2a and 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2c. ________________________.00 1234567890123453. For composite entities, Vermont composite tax due (Schedule BI-473, Line 11) . . . . . . . . . . . . . . . . . . . . 3. . ________________________.00 4. 123456789012345Vermont apportionment of entity level taxes (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. . ________________________.00 5. 123456789012345 Use Tax for taxable items on which no sales tax was charged, including online purchases . . . . . . . . . . . . .5. ________________________.00 6. 123456789012345Total tax due (ADD Lines 1, 2c, 3, 4, and 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. . ________________________.00 Form BI-471 5454 Page 1 of 2, Rev. 10/23 |
Enlarge image | Entity Name 12345678901234567890123456789012(36) FEIN Fiscal Year Ending (YYYYMMDD) *234711200* 123456789 20231231 *234711200* Page 12 PAYMENTS AND CREDITS Enter all amounts in whole dollars. 123456789012345 7. Prior Year Overpayment Applied . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. . ________________________.00 123456789012345 8. Payments with Extension (Form BA-403) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. . ________________________.00 123456789012345 9. Real estate withholding paid for this entity (Form REW-171, REW Schedule A) . . . . . . . . . . . . . . . . . . . .9. ________________________.00 123456789012345 10. Real estate withholding distributed to this entity by a different company (Schedule K-1VT, Line 12) . . .10. ________________________.00 123456789012345 11. Nonresident estimated payments paid by this entity (Form WH-435) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11. ________________________.00 12. Nonresident estimated payments distributed to this entity by a different company 123456789012345(Schedule K-1VT, Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. . ________________________.00 123456789012345 13. Total payments(ADD Lines 7 through 12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. . ________________________.00 RECONCILIATION FORM (Place at LAST page) 12345678901234514. Balance Due: If Line 6 is greater than Line 13, subtract Line 13 from Line 6 . . . . . . . . . . . . . . . . . . . . . . 14. . ________________________.00 Form pages 123456789012345 15. Payment included with this return . Make check payable toVermont Department of Taxes. . . . . . . . . 15. . ________________________.00 16. Overpayment: If Line 6 is less than the sum of Lines 13 and 15, 123456789012345ADD Lines 13 and 15, then SUBTRACT Line 6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. . ________________________.00 11 - 12 123456789012345 17. Overpayment to be credited to the next tax year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17. ________________________.00 123456789012345 18. Overpayment to be refunded . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. . ________________________.00 SIGNATURE I hereby certify that I am an officer or authorized agent responsible for the taxpayer’s compliance with the requirements of Vermont Statutes Annotated, Title 32, and that this return is true, correct, and complete to the best of my knowledge. If prepared by a person other than the taxpayer, this declaration further provides that under 32 V.S.A. § 5901, this information has not been and will not be used for any other purpose, or made available to any other person, other than for the preparation of this return unless a separate valid consent form is signed by the taxpayer and retained by the preparer. Signature of Responsible Officer Date (MM/DD/YYYY) Daytime Telephone Number 12 / 31 / 2023 802-123-1234 Printed Name Email Address (optional) 12345678901234567890123 1234567890123456789012345678901234567890123456 X Check if the Vermont Department of Taxes may discuss this return with the preparer shown. Signature of Paid Preparer Date (MM/DD/YYYY) Preparer’s Telephone Number 12 / 31 / 2023 802-123-1234 Preparer’s Printed Name Email Address (optional) 12345678901234567890123 1234567890123456789012345678901234567890123456 Firm’s Name (or yours if self-employed) EIN Preparer’s SSN or PTIN 1234567980123456789012345678901234567890 123456789 123456789 Firm’s Address (or yours if self-employed) (Street, City, State, ZIP Code) 12345678901234567890123456789012345678901234567890123456 X Check if self-employed Send return Vermont Department of Taxes and check to: 133 State Street For Department Use Only Form BI-471 Montpelier, VT 05633-1401 Ck. Amt. Init. Page 2 of 2 5454 Rev. 10/23 |