Vermont Department of Taxes 

              Form FIT-165
                                                                                             *211651100*
  Vermont Fiduciary Estimated Tax  
                                                                                             *211651100*                                                    Page 1
              Payment Voucher
                                                                                             Please PRINT in BLUE or BLACK INK

                                          Name of Estate or Trust                                                                   FEIN
  123456789012345678901234567890123456                       123456789
                                          Name of Fiduciary                                                                        Title of Fiduciary 
  123456789012345678901234567890123456                     123456789012345
         Mailing Address of Fiduciary (Number and Street/Road or PO Box)          Tax year BEGIN date (MMDDYYYY)        Tax year END date (MMDDYYYY)
  123456789012345678901234567890123456      MM /       DD /                                      YYYY     MM /       DD /                       YYYY
              Additional Line for Mailing Address of Fiduciary, if needed         Check ONE
                                                                                       Estate   Revocable               Bankruptcy Grantor      Irrevocable 
  123456789012345678901234567890123456     X    X     Trust                                                        X     Estate    X    Trust   X  Trust
              City                        State                           ZIP Code
  12345678901234567890123  12  1234567890                                         Amount of  
                                                          12345678901234 Foreign Country   this payment  .................. ____________________________ .00
  12345678901234567890123456789012

                                                                                                                                                            FORM  (Place at FIRST page)
                     MAIL THIS VOUCHER AND YOUR PAYMENT, ON OR BEFORE THE DUE DATE, TO THE ADDRESS BELOW.
                                                                                                                                                            Form pages 

                                                                                                                                   Form FIT-165
                                                                                       For Department Use Only
                                                                                                                                   Page 1 of 1
                                                                                    Ck. Amt.                       Init.
         5454                                                                                                                      Rev. 10/21               1 - 1

                                     FORM FIT-165 Instructions
              Vermont Fiduciary Estimated Tax Payment Voucher

                                                                                                                        Payment Dates*
Estimated payments are required for estates and trusts.  This voucher 
                                                                                                 1st payment ......APR 15
is provided for you to pay estimated payments toward your fiduciary tax 
liability.  Please complete the coupon above with all information on the estate                  2nd payment .....JUN 15
or trust including the Federal ID Number, and send it to the address below.                      3rd payment ......SEP 15
                                                                                                 4th payment ......JAN 15
                                                                                                *If the due date falls on a weekend or a 
                                                                                                holiday, the payment and voucher are due 
                                                                                                the next business day.

         Mail payment voucher to:                                                                                                                           FORM  (Place at LAST page)
                                                                                                                                                            Form pages 
         Taxpayer Services Division-Income Tax                            Email:       tax.estate@vermont.gov
         Vermont Department of Taxes                                      Telephone: (802) 828-6820
         PO Box 1700                                                      Fax:         (802) 828-2720
         Montpelier, VT  05601-1700
                                                                                                                                                            1 - 1

                                                                                                                   Form FIT-165 Instructions
                                                                                                                                   Rev. 10/23