PDF document
- 1 -
Vermont Department of Taxes     133 State Street     Montpelier, VT  05633-1401
Phone:  (802) 828-6851
                                                                                                   *191731100*
      VT Form
                      PROPERTY TRANSFER
                                                                                                   *191731100*
 PTT-173              TAX PAYMENT VOUCHER                                                                                                Page 2

Please print clearly, using Blue or Black Ink Only

                                                                                                   Web request key / Confirmation code
TRANSFEREE #1  (From Form PTT-172, Section B) 
      Entity TRANSFEREE Name                                                                          Federal ID Number 

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

 TRANSFEREE Mailing Address Following Transfer                                                     Daytime Telephone Number

 Line 2 for Mailing Address Following Transfer (if needed)                                         Date of Closing (MM DD YYYY)

 City                                                                 State ZIP Code                  For Department Use Only

 Foreign Country (if not United States)                               Email Address                                                      FORM  (Place at FIRST page)
                                                                                                                                         Form pages 

  1.  Did you determine a portion of value was eligible for the special  
      “principal residence” rate (see PTT-172, Line J1)?  .........................1.              c Yes                    c No
                                                                                                                                         2 - 2
  2.  Did you claim exemption “99” on your return (see PTT-172, Line E1)? .........2.              c Yes                    c No

  3.  Amount of this payment.  If “$0,” DO NOT file  . . . . . . . . . . . . . . . . . . . 3.  ________________________________

Make check payable to Vermont Department of Taxes and send with this voucher to:
                 Vermont Department of Taxes
                 133 State Street
                 Montpelier, VT  05633-1401

If you would like assistance or have questions, please call 802-828-6851.

    Clear ALL fields                    Save and go to Important Printing Instructions                       Save and Print

                                                                                                                                         FORM  (Place at LAST page)
                                                                                                                                         Form pages 

                                                                                                                           Form PTT-173
5454                                                                                                                           Rev. 11/19
                                                                                                                                         2 - 2






PDF file checksum: 1710138603

(Plugin #1/9.12/13.0)