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4 Vermont Department of Taxes 4
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6 Schedule BA-410 *234101100* 6
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Vermont Corporate and Business *234101100*
8 8 Page 2
9 Income Tax Affiliation Include with Form CO-411 9
10 or Form BI-471 10
11 REQUIRED FOR COMBINED AND CONSOLIDATED RETURNS 11
12 Please provide information for all affiliates/subsidiaries/entities contributing income/activity to Vermont Unitary Group. 12
13 Entity Name (same as on Form CO-411 or Form BI-471) Fiscal Year Ending (YYYYMMDD) FEIN 13
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12345678901234567890123456789012(36) 20231231 123456789
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Pass-
16 Unitary through Has 16
17 Disregarded Vermont 17
group entity
18 Affiliate Name FEIN member? entity? directly sales or 18
(“Y” or “N”) activity?
19 (“Y” or “N”) owned? (“Y” or “N”) 19
20 (“Y” or “N”) 20
21 1. 12345678901234567890123456789012(36) 123456789 Y N Y N 21
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23 2. 12345678901234567890123456789012(36) 123456789 Y N Y N 23
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25 3. 12345678901234567890123456789012(36) 123456789 Y N Y N 25 FORM (Place atFIRST page)
26 26 Form pages
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52 52 FORM (Place at LAST page)
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61 61
Schedule BA-410
62 USE ADDITIONAL SCHEDULES, IF NECESSARY Page 1 of 1 62
63 5454 Rev. 10/23 63
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