Vermont Department of Taxes     133 State Street     Montpelier, VT  05633-1401
Phone:  (802) 828-6851
     VT Form                                                                                                     *191781100*
                       VERMONT LAND GAINS TAX RETURN 
LGT-178                     To be completed by Transferor (Seller)                                               *191781100*
                                                                                                                                                                     Page 8
NOTE:  H.541 of the 2019 Legislative Session changed the definition of “land” subject to the Land Gains Tax to encompass only Vermont 
land that has been purchased and subdivided by the transferor within six years prior to the sale or exchange of the land, or timber or 
rights to timber when sold within six years of their purchase, provided the underlying land is also sold within six years.  Underlying land 
means the land from which timber or timber rights have been separated, whether subdivided or not.  These changes are effective with 
returns filed after Jan. 1, 2020.

A.   TRANSFEROR’S (Seller’s) INFORMATION
     Entity TRANSFEROR Name                                                                                         Federal ID Number 

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

TRANSFEROR Mailing Address Following Transfer                                                                    Daytime Telephone Number

Line 2 for Mailing Address Following Transfer (if needed)                                                           For Department Use Only

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

B.   TRANSFEREE’S (Buyer’s) INFORMATION
     Entity TRANSFEREE Name                                                                                         Federal ID Number 
                                                                                                                                                                     8 - 10
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)                                                           For Department Use Only

City                                                                       State ZIP Code

Foreign Country (if not United States)                                     Email Address

C.   PROPERTY INFORMATION
Property Physical Location - Number and Street or Road Name                                                      Land Size (in acres)

City or Town                                                               Check if property is located          SPAN  
                                                                           in multiple cities or towns

D.   HOLDING PERIOD
Date Acquired by Transferor (mm dd yyyy) Date of this Closing (mm dd yyyy)       Time Held
                                                                                                         _________ Years                 _________ Months 

E.   EXEMPTIONS
     E1.     If transfer is exempt from Land Gains Tax, enter exemption number (see quick reference guide)  . . . . . .               E1.  __________

             E1a.  If Line E1 is “08,” enter description  . . . . . . . . . . . . . . .  . E1a.  __________________________________________

Vendor ID Code (bottom left)                                (continued on next page)
• 5432 - Booklet forms                                                                                                                   Form LGT-178
                                                                                                                                                          Page 1 of 3
• 5433 - Singles
5454                                                                                                                                                      Rev. 12/19
• 5434 - HS Booklet
• 5454 - Web forms

Transferee’s Name _____________________________________________________
Property Location _____________________________________________________
Date of this Closing ____________________________________________________ 
                                                                                                         *191781200*
                                                                                                         *191781200*
                                                                                                                                                                    Page 9
F. TRANSFER INFORMATION
   F1. How did the transferor acquire this property? (see quick reference guide)   . . . . . . . . . . . . . . .  .  .  .  .  .  .  .  .  .          F1.  __________

       F1a.  If Line F1 is “04,” enter description  . . . . . . . . . . . . . . . . F1a.  __________________________________________

   F2. Interest conveyed in this transfer (see quick reference guide)   . . . . . . . . . . . . . . . . . . . . . . . . .  .  .  .  .  .  .  .  .  . F2.  __________

       F2a.  If Line F2 is “07,” enter percent of interest here  . . . . . . . . . . . . . . . . . . . . F2a. _________________ ._______                 %
       F2b.  If Line F2 is “08,” enter description  . . . . . . . . . . . . . . .  . F2b.  __________________________________________

   F3. Type of building construction at time of transfer (see quick reference guide)  . . . .            F3.  ________   ________    ________

       F3a.  If Line F3 is “05,” enter number of units transferred  . . . . . . . . . . . . . . . . . . . . . . . . . . .  .  .  .  .  .  .  .  . F3a.  __________

       F3b.  If Line F3 is “06,” enter number of dwelling units transferred   . . . . . . . . . . . . . . . . . . .  .  .  .  .  .  .  .  .       F3b.  __________

       F3c.  If Line F3 is “20,” enter description  . . . . . . . . . . . . . . . . F3c.  __________________________________________

G. SALE INFORMATION

   G1. Value paid or transferred  
       (from Form PTT-172, Line J10)     . . . . . . . . . . . . .  . G1.  ________________________

   G2. Selling price of timber, if applicable 
       (see instructions)  . . . . . . . . . . . . . . . . . . . . . . . . .  . G2.  ________________________

   G3. Add Line G1 and Line G2  . . . . . . . . . . . . . . . . . .  . G3.  ________________________

   G4. Total selling expenses  
       (from Schedule LGT-179, Line B5)  . . . . . . . . . .  . G4.  ________________________

   G5. Adjusted selling price (Subtract Line G4 from Line G3)  . . . . . . . . . . . . . . . . . . . . . . .  . G5.  ________________________

H. LAND AND STRUCTURES COST INFORMATION

   H1.  Total cost of land 
       (from Schedule LGT-179, Line C6)  . . . . . . . . . .  . H1.  ________________________

   H2. Total cost of structures 
       (from Schedule LGT-179, Line D5)  . . . . . . . . . .  . H2.  ________________________

   H3. Basis of timber or timber rights, if applicable 
       (see instructions)  . . . . . . . . . . . . . . . . . . . . . . . . .  . H3.  ________________________

   H4.  Total cost of land and structures (Add Lines H1 through H3)  . . . . . . . . . . . . . . . . . . .  . H4.  ________________________

   TOTAL GAIN OR LOSS

   H5.  Total gain or loss (Subtract Line H4 from Line G5)  . . . . . . . . . . . . . . . . . . . . . . . . . . .  . H5.  ________________________

                                               (continued on next page)

                                                                                                                                                     Form LGT-178
                                                                                                                                                         Page 2 of 3
5454                                                                                                                                                     Rev. 12/19

Transferee’s Name _____________________________________________________
Property Location _____________________________________________________
Date of this Closing ____________________________________________________ 
                                                                                                       *191781300*
                                                                                                       *191781300*
                                                                                                                                                                   Page 10

I. TAX CALCULATION

   I1.     Total gain or loss (Amount from Line H5)  . . . . . .  . I1.  ________________________

   I2.     Gain as a percentage of basis   . . . . . . . . . . . . . . . .  . I2.  ________________________

   I3.     Taxable gain   . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . I3.  ________________________

           I3a.  Will you use the statewide percentages from Technical Bulletin 34 to 
               allocate gain on Form LGT-179, buildings Schedule A?  . . . . . . . . . . . . . . . . . . .  .I3a.                        c Yes         c No

   I4.     Tax rate  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . I4.  ________________________

   I5.     Total Tax Due (Multiply Line I3 by Line I4)  If a Commissioner’s Certificate was 
           issued, enter the withholding amount required.   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  .I5.  ________________________

   I6.     If a Vermont Commissioner’s Certificate was 
                                                                                                                                                                   FORM  (Place at LAST page)
           issued, enter Certificate Number  . . . . . . . . . . . . . .  . I6.  ________________________
                                                                                                                                                                   Form pages
   I7.     Tax due from transferee:  If transferee fails to 
           meet all requirements of the exemption  
           claimed on Line E1, transferee is liable for .  .  .  .  . I7..  . ________________________

J. WITHHOLDING REFUND CALCULATION                                                                                                                                  8 - 10
   J1.     Amount of advance payment or tax
           withheld by transferee  . . . . . . . . . . . . . . . . . . . . . .  .J1.  ________________________

   J2.     REFUND  (If Line I5 less than Line J1, subtract Line I5 from Line J1)  . . . . . . . . . . . .                            J2.  ________________________

   J3.     TAX DUE after credits applied  (If Line J1 is less than Line I5, 
           subtract Line J1 from Line I5)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J3.  ________________________

       REMINDER:  If you used Schedule LGT-179 to complete this return, it must be submitted with this return.

K. SIGNATURES
We hereby certify this return is true, correct, and complete to the best of our knowledge.
   Signature of Primary Transferor                                                        Printed name                                             Date

   May the Dept. of Taxes discuss this return with the preparer shown?   c  Yes           c  No
           Preparer’s                                                                                                  Date
           signature
           Preparer’s                                                                                                  Preparer’s Telephone Number
           printed name
Preparer’s                                                                                                             (                          )
           Firm’s name (or yours if self-employed) and address
Use Only
           Preparer’s email address 

               Send completed return to:
                       Vermont Department of Taxes                                                                                                     Form LGT-178
                       133 State Street                                                                                                                Page 3 of 3
5454                   Montpelier, VT  05633-1401                                                                                                      Rev. 12/19

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