Vermont Department of Taxes 

              2023 Schedule IN-113                                                                                                  *231131100*
 Vermont Income Adjustment Calculations                                                                                             * 23 1131100*
                                                                                                                                        Please PRINT in BLUE or BLACK INK                                         Page 25
       Nonresidents and Part-Year Residents Must Complete Parts I and II                                                                INCLUDE WITH FORM IN-111
       Full-Year Residents with Adjustments Complete only Part II
               Taxpayer’s Last Name                                                                       First Name                MI  Taxpayer’s Social Security Number
  12345678901234567       12345678901234567    1   123456789

PART I.     Enter figures as they appear on your federal return or recomputed federal return in Column A and list the Vermont portion in                                                                          FORM  (Place at FIRST page)
            Column B. See instructions.                                                                                                                                                                           Form pages 
                                          Dates of Vermont residency in 2023                                                            Name of State(s), Canadian province, or 
     From                                                           To                                                                  country during non-Vermont residency 
           (MMDDYYYY): MM /       DD /          YYYY          (MMDDYYYY):                                 MM /       DD /  YYYY                      (use standard 2-character abbreviation)12

                                                                                                                                                                                                                  25 - 26
                                                                                                          A.                                                           B.
                                                                                                          Federal Amount $                                             Vermont Portion $

                                1. Wages, salaries, tips, etc.  . . . . . . . . . . . . . . . . . .1A.  __________________________12345678901234             .00 1B. __________________________12345678901234  .00

                               2. Taxable interest .............. . . . . . . . . . . . . 2A.  __________________________12345678901234             .00 2B. __________________________12345678901234           .00

                                3. Ordinary dividends . . . . . . . . . . . . . . . . . . . . . . .3A.  __________________________12345678901234             .00 3B. __________________________12345678901234  .00

                                4. Taxable IRAs, pensions, and annuities ........ 4A.  __________________________12345678901234             .00 4B. __________________________12345678901234                   .00

                                5. Taxable Social Security .......   ........... 5A.  __________________________12345678901234             .00 5B. __________________________12345678901234                    .00

                                6. Taxable refunds of state and local income taxes 6A.  __________________________12345678901234             .00 6B. __________________________12345678901234                  .00

                                7. Alimony received ............ . . . . . . . . . . . . 7A.  __________________________12345678901234             .00 7B. __________________________12345678901234            .00

                                8. Business income or loss . . . . . . . . . . . . . . . . . . .8A.  __________________________12345678901234             .00 8B. __________________________12345678901234     .00

                                9. Capital gain or loss   . . . . . . . . . . . . . . . . . . . . . .9A.  __________________________12345678901234             .00 9B. __________________________12345678901234.00
  10.  Rents, royalties, partnerships,  
                              S corporations, trusts, etc . . . . . . . . . . . . . . . . . 10A.  __________________________12345678901234             .00 10B. __________________________12345678901234       .00

                               11. Farm income or loss  . . . . . . . . . . . . . . . . . . . . .11A.  __________________________12345678901234             .00 11B. __________________________12345678901234  .00

                                12.  Unemployment compensation  . . . . . . . . . . . . . 12A.  __________________________12345678901234             .00 12B. __________________________12345678901234         .00

                                13. Other: Specify ............... . . . . . . . . . . . 13A.  __________________________12345678901234             .00 13B. __________________________12345678901234          .00
  14.  TOTAL INCOME  
                              (ADD Lines 1 through 13) . . . . . . . . . . . . . . . 14A.  __________________________12345678901234             .00 14B. __________________________12345678901234              .00

                                                                                                                                                                       Schedule IN-113
                                                                                                                                                                       Page 1 of 2
                5454                                                                                                                                                   Rev. 10/23

                          Taxpayer’s Last Name                   Social Security Number
        12345678901234567    123456789
                                                                                                                           *231131200*
                                                                                                                           * 23 1131200*
                                                                                                                                                                                                                                                               Page 26
                                                                                            Column A.                                                              Column B.
                                                                                            Federal Amount $                                                   Vermont Portion $
  15.  IRA, Keogh/SEP/SIMPLE  
                              (Reported on federal Form 1040) . . . . . . . . . . 15A.  _______________________12345678901234             .00          15B.  _________________________12345678901234                                                       .00 

       12345678.       12345678.  Self _________________   Spouse _________________                            
  16.  Student Loan Interest  
                              (Reported on Form 1040) . . . . . . . . . . . . . . . . 16A.  _______________________12345678901234             .00      16B. 12345678901234______________________                                                           .00 FORM  (Place atLAST page)
                                                                                                                                                                                                                                                               Form pages 
  17.  Employee Deductions: Reservists,  
       Performing Artists, Fee-basis Gov’t  
                              Officials (Reported on Form 1040)  ........ 17A.  _______________________12345678901234             .00                  17B. 12345678901234______________________                                                           .00
  18.  Self-Employment Deductions: Tax and  
                              Health Insurance (Reported on Form 1040) .. 18A.  _______________________12345678901234             .00                  18B. 12345678901234______________________                                                           .00
  19.  Health Savings Account                                                                                                                                                                                                                                  25 - 26
                              (Reported on Form 1040) . . . . . . . . . . . . . . . . 19A.  _______________________12345678901234             .00      19B. 12345678901234______________________                                                           .00

                                20.  Moving Expenses (Reported on Form 1040) . 20A.  _______________________12345678901234             .00             20B. 12345678901234______________________                                                           .00
  21.  Penalty on Early Withdrawal of Savings  
                              (Reported on Form 1040) . . . . . . . . . . . . . . . . 21A.  _______________________12345678901234             .00      21B. 12345678901234______________________                                                           .00

                                22. Alimony Paid (Reported on Form 1040) .... 22A.  _______________________12345678901234             .00              22B. 12345678901234______________________                                                           .00
  23.  Domestic Production Activities  
                              (Reported on Form 1040) . . . . . . . . . . . . . . . . 23A.  _______________________12345678901234             .00      23B. 12345678901234______________________                                                           .00
  24.  Educator Expenses and Tuition & Fees  
                              (Reported on Form 1040) . . . . . . . . . . . . . . . . 24A.  _______________________12345678901234             .00      24B. 12345678901234______________________                                                           .00
  25.  Deductions not listed above but reported  
                              on Form 1040 ............... . . . . . . . . . . 25A.  _______________________12345678901234             .00             25B. 12345678901234______________________                                                           .00
  26. TOTAL ADJUSTMENTS 
                              (ADD Lines 15 through 25)  . . . . . . . . . . . . . 26A.  _______________________12345678901234             .00         26B. 12345678901234______________________                                                           .00

                                                          12345678901234  27. Adjusted Gross Income (SUBTRACT Line 26A from Line 14A)  ................... . . . . . . . . . . . .27.  ______________________                                              .00

                                                          12345678901234  28. Vermont Portion of AGI (SUBTRACT Line 26B from Line 14B) ................... . . . . . . . . . . . .28.  ______________________                                              .00
  29.  Non-Vermont Income (SUBTRACT Line 28 from Line 27)  
                                                          12345678901234Also enter on Part II, Line 31 below . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29.   _________________________.00

PART II.  Adjustment for Vermont Exempt Income and Military Exempt Income
  30.  Adjusted Gross Income. If Part I completed, enter Line 27 amount.  
                                                          12345678901234Otherwise, enter amount from Form IN-111, Line 1 ............................... . . . . . . . . . . . .30.  ______________________                                                .00

                              12345678901234  31.  Non-Vermont Income (Line 29 above)  ....... 31.  _______________________.00
  32.  Military pay. Number of months  
           on active duty ______12                (See instructions) ...... 32.  _______________________12345678901234.00

                                                          12345678901234 33. Total (ADD Lines 31 and 32) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33.  ______________________.00

                                                          12345678901234 34.  Vermont Income (SUBTRACT Line 33 from Line 30) ............................ . . . . . . . . . . . .34.  ______________________.00
  35.  INCOME ADJUSTMENT % (DIVIDE Line 34 by Line 30 MULTIPLY,                                                the result by 100 and  
                                                               carry the result out to the fourth decimal place.)  Also enter on Form IN-111, Line 15 (See instructions) .....35.  ________123.1234__________%

                                                                                                                                                               Schedule IN-113
                                                                                                                                                                                   Page 2 of 2
               5454                                                                                                                                                                Rev. 10/23