Vermont Department of Taxes 

             Schedule BA-404                                                          *234041100*

 Vermont Tax Credits Earned, Applied,                                                 *234041100*
                                                                                                                            Page 5
      Expired, and Carried Forward
                                                                                          Include with Form CO-411 
PRINT in BLUE or BLACK INK                                                                                or Form BI-471 
                                                                                                          or Form BI-476
Enter all amounts in whole dollars.
      Entity Name (same as on Form CO-411, Form BI-471, or Form BI-476)     Fiscal Year Ending (YYYYMMDD) FEIN
  12345678901234567890123456789012(36)       20231231        123456789

                                           (A)                          (B)           (C)                 (D)
                                           Amount Carried               Amount Earned Amount Applied      Amount Carried 
                                           Forward                      Current Year  Current Year        Forward to Future 
                                           from Prior Years                                               Years

  1.  Research and Development 
                    (32 V.S.A. § 5930ii)   123456789012  123456789012  123456789012  123456789012
                                                                                                                            FORM  (Place at FIRST page)
  2.  Charitable Housing                                                                                                    Form pages 
                    (32 V.S.A. § 5830c)    123456789012  123456789012  123456789012  123456789012

  3.  Affordable Housing  
                    (32 V.S.A. § 5930u)    123456789012  123456789012  123456789012  123456789012
  4.  Qualified Sale of Mobile                                                                                              5 - 5
      Home Park  
                    (32 V.S.A. § 5828)     123456789012  123456789012  123456789012  123456789012
  5.  Vermont Entrepreneurs’ 
      Seed Capital Fund  
                    (32 V.S.A. § 5830b)    123456789012  123456789012  123456789012  123456789012

  6.  Code Improvement  
                    (32 V.S.A. § 5930cc(c))123456789012  123456789012  123456789012  123456789012

  7.  Historic Rehabilitation  
                    (32 V.S.A. § 5930cc(a))123456789012  123456789012  123456789012  123456789012

  8.  Facade Improvement  
                    (32 V.S.A. § 5930cc(b))123456789012  123456789012  123456789012  123456789012
  9.  Investment Tax Credit - 
      Solar Energy  
                    (32 V.S.A. § 5822(d))  123456789012  123456789012  123456789012  123456789012
  10. Investment Tax Credit - 
      Other  
                    (32 V.S.A. § 5822(d))  123456789012  123456789012  123456789012  123456789012
                                                                                                                            FORM  (Place at LAST page)
  11.  TOTAL FOR ALL                                                                                                        Form pages 
      CREDITS (ADD 
                    Lines 1 through 10)    123456789012  123456789012  123456789012  123456789012

                                                                                                                            5 - 5

                                                                                                          Schedule BA-404
                                                                                                          Page 1 of 1
5454                                                                                                      Rev. 10/23