Vermont Department of Taxes 

                 Form CO-422                                                      *234221100*

Vermont Corporate Income Tax                                                      *234221100*
                                                                                                                                         Page 1
         Payment Voucher
                                                                                  If you filed electronically, DO NOT include 
Use this form if not submitting payment with Form CO-411.                         a copy of that return with this payment.
(The Department does accept payments with Form CO-411.)

Entity Name (Principal Vermont Corporation)                     FEIN 
  12345678901234567890123456789012(36)     123456789 
Address                                                         Tax year BEGIN date (YYYYMMDD) Tax year END date (YYYYMMDD)
  12345678901234567890123456789012(36)      20230101         20231231
Address (Line 2)                                   
                                                                Amount of this payment.  
  12345678901234567890123456789012(36)  
City                                        State ZIP Code      Use WHOLE DOLLARS.
  12345678901234567(21)    12  1234567890               If $0, DO NOT file ............$ ______________________________123456789012345.00
                                         Foreign Country 
  1234567890123456789012345678(32)
                                                                                                                                         FORM  (Place at FIRST page)
        Send return     Vermont Department of Taxes              Phone:  (802) 828-5723                                                  Form pages 
        and check to:   133 State Street
                        Montpelier, VT  05633-1401                   For Department Use Only   Form CO-422
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                                                                  Ck. Amt.               Init.
5454                                                                                                  Rev. 10/23
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Instructions for Vermont Corporate Income Tax Return Payment Voucher
                                                  Form CO-422
General Information                                             Instructions
Use Form CO-422 to pay Corporate Income taxes.                  •          Print in blue or black ink.
Do not include Form CO-422 if you are sending payments with     •          Enter the beginning and ending date of the 
another return such as:                                                    entity’s tax year in the required format - 
  •     CO-411 - Corporate Income Tax Return                               YYYYMMDD.
  •     CO-414 - Corporate Estimated Tax Payment Voucher        •          Enter the Federal Employer Identification 
                                                                           Number (FEIN).
  •     BA-403 - Application for Extension of Time to File 
        Vermont Corporate/Business Income Tax Returns           •          Enter the business name and address, 
                                                                           including country, if other than the United 
CO-422 may be used, for example, if:
                                                                           States.
  •     You mailed your return or payment coupon, but forgot to 
                                                                •          Enter the total amount of payment included 
        include a check.
                                                                           with this coupon. Enter a whole dollar 
  •     You or your tax preparer filed your documents                      amount.
        electronically, and you want to send a check separately.
                                                                •          Do not file Form CO-422 if no payment is 
Do not use Form CO-422 for Business Income tax accounts.                   due.
Business Income tax filers should use Form WH-435, Vermont                                                                               FORM  (Place at LAST page)
Estimated Income Tax Payments for Nonresident Shareholders,     Mail voucher and payment to:                                             Form pages 
Partners, or Members, to make estimated payments on behalf of              Vermont Department of Taxes
nonresident owners, or Form BI-470, Vermont Business Income                133 State Street
Tax Payment Voucher, in lieu of this form.                                 Montpelier, VT  05633-1401

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                                                                                                      Rev. 10/23