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Vermont Department of Taxes
Schedule FIT-K-1VT-F *23K1F1100*
Vermont Beneficiary Information *23K1F1100*
Page 5
for Fiduciaries Include with Form FIT-161
Name of Estate or Trust FEIN Tax Year End Date (MM/DD/YYYY)
123456789012345678901234567890123456 123456789 MM / DD / YYYY
HEADER INFORMATION - REQUIRED ITEMS
Entity Name FEIN
123456789012345678901234567890123456 123456789
OR IndividualFirstInitialOR Social Security Number LastNameName (Beneficiary)
12345678901234567 12345678901234567 1 123456789
Address Recipient Type
123456789012345687901234567890123456 (I,I C, S, L, P, X, or T)
Address, Line 2 (if needed)
Residency Vermont
123456789012345678901234567890123456 Status X Resident X Nonresident
City State ZIP Code or Postal Code
123456789012345678901 12 1234567890 X Check here if this your FINAL return
ForeignPercentage of Estate’s or Trust’s income or loss to this recipient. FORM (Place atFIRST page)Country (if not United States)
12345678901234567890123456789012 Calculate percentage to two places to the right of the decimal point. 100.00 % Form pages
VERMONT RESIDENT BENEFICIARY
123456789012 1. Beneficiary’s share of distributed net income allocated to Vermont . . . . . . . . . . . . . . . . . . . . . 1.. ______________________.00
123456789012 2. Interest / dividends from obligations of other states . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.. ______________________.00 5 - 5
123456789012 3. Interest / dividends from U .S . obligations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.. ______________________.00
VERMONT NONRESIDENT BENEFICIARY
123456789012 4a. Vermont Business Income . . . . . . . . . . . . . . . . . . . . 4a.. ______________________ .00
123456789012 4b. Capital gain or loss allocated to Vermont . . . . . . . . 4b.. ______________________ .00
123456789012 4c. Partnership, S Corporation, LLC . . . . . . . . . . . . . . . 4c.. ______________________ .00
123456789012 4d. Rent, royalties, estates, trusts . . . . . . . . . . . . . . . . . . 4d.. ______________________ .00
123456789012 4e. Farm income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4e. ______________________ .00
123456789012 4f. Other income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4f. ______________________ .00
123456789012 4g. Total nonresident income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4g.. ______________________.00
PAYMENT INFORMATION
123456789012 5. Total annual nonresident estimated payments allocated to this beneficiary . . . . . . . . . . . . . . . . 5.. ______________________.00
123456789012 6. Total annual real estate withholding payments allocated to this beneficiary . . . . . . . . . . . . . . . .6. ______________________.00
123456789012 7. Other payments allocated to this beneficiary (1099 withholding, estimates paid) . . . . . . . . . . . 7.. ______________________.00 FORM (Place atLAST page)
8. Share of total federal bonus depreciation difference . Form pages
123456789012Enter on Schedule IN-112, Line 4 or Line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.. ______________________.00
123456789012 9. Share of total state and local taxes deducted on federal filing . . . . . . . . . . . . . . . . . . . . . . . . . . 9.. ______________________.00
Schedule FIT-K-1VT-F
5 - 5
Page 1 of 1
5454 Rev. 10/23