Vermont Department of Taxes 

          2023 Schedule IN-113                                                                           *231131100*
 Vermont Income Adjustment Calculations                                                                  *231131100*
                                                                                                             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

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):   /        /          (MMDDYYYY):                       /        /                          (use standard 2-character abbreviation)

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

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

  2.  Taxable interest .............. . . . . . . . . . . . . 2A.  __________________________ .00            2B. __________________________.00

  3.  Ordinary dividends . . . . . . . . . . . . . . . . . . . . . . . 3A.  __________________________ .00   3B. __________________________.00

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

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

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

  7.  Alimony received ............ . . . . . . . . . . . . 7A.  __________________________ .00              7B. __________________________.00

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

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

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

  12.  Unemployment compensation  . . . . . . . . . . . . . 12A.  __________________________ .00             12B. __________________________.00

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

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

               Taxpayer’s Last Name                            Social Security Number

                                                                                             *231131200*
                                                                                             *231131200*
                                                                                                                                                                                             Page 26
                                                               Column A.                                                                                       Column B.
                                                               Federal Amount $                                                                                Vermont Portion $
  15.  IRA, Keogh/SEP/SIMPLE  
       (Reported on federal Form 1040) . . . . . . . . . .     15A.  _______________________ .00            15B.   _________________________.00 

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

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

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

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

  28.  Vermont Portion of AGI (SUBTRACT Line 26B from Line 14B) ................... . . . . . . . . . . . .28.  ______________________ .00
  29.  Non-Vermont Income (SUBTRACT Line 28 from Line 27)  
       Also 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.  
       Otherwise, enter amount from Form IN-111, Line 1 ............................... . . . . . . . . . . . .30.  ______________________ .00

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

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

  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.  ________ . __________%

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

       Clear ALL fields                          Save and go to Important Printing Instructions                                                                Save and Print