Vermont Department of Taxes 

     Schedule BI-472                                                            *234721100*

     Vermont Non-Composite                                                      *234721100*
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PRINT in BLUE or BLACK INK                                                                                                                     Include with Form BI-471

     Entity Name (same as on Form BI-471)                                   Fiscal Year Ending (YYYYMMDD)                                      FEIN

                                                                                                                                               Enter all amounts in whole dollars.

  1. Income Attributable to Vermont (Schedule BI-477, Line 28)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . 1.  ________________________ .00

  2. Other adjustments to income attributable to Vermont  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . 2.  ________________________ .00

  3. Total Income Attributable to Vermont (ADD Lines 1 and 2)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . 3.  ________________________ .00

  4. Percentage of income from Line 3 passed through to nonresidents  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . 4.  __________ . ______________%

  5. Total income passed through to nonresidents (MULTIPLY Line 3 by Line 4)  . . . . . . . . . . . . . . . . . . . . .  . 5.  ________________________ .00
                                                                                                                                                                                  FORM  (Place at FIRST page)
  6. Nonresident estimated payment requirement (MULTIPLY Line 5 by 6.6% (0.066))  . . . . . . . . . . . . . . . .  . 6.  ________________________ .00                             Form pages 

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                                                                                                                                                                                  FORM  (Place at LAST page)
                                                                                                                                                                                  Form pages 

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                                                                                                                                               Schedule BI-472
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5454                                                                                                                                           Rev. 10/23