Vermont Department of Taxes     133 State Street     Montpelier, VT  05633-1401
Phone:  (802) 828-6851
 VT Schedule                                                                                     *191791100*
                      VERMONT LAND GAINS SCHEDULES 
 LGT-179                   To be completed by Transferor (Seller)                                                                                                   Page 4
                                                                                                 *191791100*

Please PRINT in BLUE or BLACK INK                                                                                                  ATTACH TO FORM LGT-178

    Entity TRANSFEROR Name                                                                                                         Federal ID Number 

 OR Individual TRANSFEROR Last Name       First Name                                     Initial OR                                Social Security Number

 Property Location                                                                                              Date of Closing

A.  BUILDINGS   Complete this section if the transfer includes buildings.

    A1.  Value of land, excluding buildings  
        (see instructions)  . . . . . . . . . . . . . . . . . . . . . . . . . . A1.  ________________________

    A2.  Value paid or transferred 
        (from Form LGT-178, Line G1)  . . . . . . . . . . . . . . A2.  ________________________                                                                     FORM  (Place at FIRST page)
    A3.  Percentage of gain on land                                                                                                                                 Form pages 
        (Divide Line A1 by Line A2)   . . . . . . . . . . . . . . . .A3.  _____________ ._______ %
    A4.  Total realized gain .   
        (from Form LGT-178, Line I1)  . . . . . . . . . . . . . . . A4.  ________________________
                                                                                                                                                                    4 - 6
    A5. Taxable land gain (Multiply Line A3 by Line A4) .  If an exemption was not claimed   
        on Form LGT-178, Line E1, enter the amount from Line A5 onto Form LGT-178,  
        Line I3 .  If an exemption was claimed on Form LGT-178, Line E1, complete  
        Schedule LGT-179, Part F  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . A5.  ________________________

B.  SELLING EXPENSES

    B1. Legal fees   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B1.  ________________________

    B2. Sales commissions  . . . . . . . . . . . . . . . . . . . . . . . . . B2.  ________________________

    B3. Advertising  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B3.  ________________________

    B4. Other (describe) ________________________  . . B4.  ________________________

    B5. Total selling expenses (Add Lines B1 - B4) .   
        Enter this figure on Form LGT-178, Line G4 .   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . B5.  ________________________

                                                    (continued on next page)

                                                                                                                                       Schedule LGT-179
                                                                                                                                                         Page 1 of 3
5454                                                                                                                                                     Rev. 11/19

Transferee’s Name _____________________________________________________
Property Location _____________________________________________________
Date of this Closing ____________________________________________________ 
                                                                                      *191791200*

                                                                                      *191791200*
                                                                                                                                                             Page 5

C. COST OF LAND

   C1.  Cost of land  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C1.  ________________________

   C2. Cost of land improvements (attach list)   . . . . . . . . C2.  ________________________

   C3.  Transfer tax at purchase  . . . . . . . . . . . . . . . . . . . . . C3.  ________________________

   C4.  Legal fees at purchase  . . . . . . . . . . . . . . . . . . . . . . C4.  ________________________

   C5.  Other (describe) _______________________  . . . C5.  ________________________

   C6.  Total cost of land  (Add Lines C1 - C5) .   
       Enter this figure on Form LGT-178, Line H1 .   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . C6.  ________________________

D. COST OF STRUCTURES

   D1. Cost of structures  . . . . . . . . . . . . . . . . . . . . . . . . . . D1.  ________________________

   D2.  Other (describe) ________________________  . . D2.  ________________________

   D3.  Other (describe) ________________________  . . D3.  ________________________

   D4.  Other (describe) ________________________  . . D4.  ________________________

   D5. Total cost of structures  (Add Lines D1 - D4) .   
       Enter this figure on Form LGT-178, Line H2  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . D5.  ________________________

E. INSTALLMENT SALES

   E1. Amount of this principal payment  . . . . . . . . . . . . . E1.  ________________________

   E2. Amount reported on Form LGT-178, Line G1  . . . E2.  ________________________

   E3. Divide Line E1 by Line E2  . . . . . . . . . . . . . . . . . . E3.  ________________________

   E4. Amount reported on Form LGT-178, Line I5  . . . . E4.  ________________________

   E5. Multiply Line E3 by Line E4   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . E5.  ________________________

                               (continued on next page)

                                                                                                                                    Schedule LGT-179
                                                                                                                                    Page 2 of 3
5454                                                                                                                                Rev. 11/19

Transferee’s Name _____________________________________________________
Property Location _____________________________________________________
Date of this Closing ____________________________________________________ 
                                                                                   *191791300*

                                                                                   *191791300*
                                                                                                                                                 Page 6

F. ACRES BEYOND THOSE ALLOWED BY EXEMPTION

   F1. Total number of acres transferred  . . . . . . . . . . . . .            F1.  ________________________

   F2. Total number of exempt acres transferred 
       (see instructions)  . . . . . . . . . . . . . . . . . . . . . . . . . . F2.  ________________________

   F3. Percentage of area used for exempt purposes  . . . .                    F3.  ________________________

   F4. Exempt area (Multiply Line F2 by Line F3)  . . . . .                    F4.  ________________________

   F5. Nonexempt area (Subtract Line F4 from Line F1)                          F5.  ________________________

   F6. Percentage of gain from nonexempt acres 
       (Divide Line F5 by Line F1)  . . . . . . . . . . . . . . . . .          F6.  ________________________
                                                                                                                                                 FORM  (Place at LAST page)
   F7. Taxable land gain  (Multiply Line F6 by Line A5 .  If transfer did not                                                                    Form pages
       include buildings, multiply Line F6 by Form LGT-178, Line I1 .)   
       Enter this amount on Form LGT-178, Line I3   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F7.  ________________________

                                                                                                                                                 4 - 6

                                                                                                                        Schedule LGT-179
                                                                                                                        Page 3 of 3
5454                                                                                                                    Rev. 11/19

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