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               Vermont Department of Taxes 
                                                                  For the year 
                                                                 Jan. 1 - Dec. 31, 
                  2023 Form RCC-146                               2023                                  *231461100*
            Vermont Renter Credit Claim                                                                 *231461100*
                                                                                                                                                                                 Page 27
                     Claimant’s Last Name                         First Name                               MI                    Claimant’s Social Security Number    

               Spouse’s/CU Partner’s Last Name                    First Name                               MI               Spouse’s or CU Partner’s Social Security Number    

                                Mailing Address (Number and Street/Road or PO Box)                                           Claimant’s Date of Birth (MM/DD/YYYY)    
                                                                                                                                 /        /
                             City                      State                       ZIP Code                                       County of Rental Unit                          FORM  (Place at FIRST page)
                                                                                                                                                                                 Form pages 
   Vermont School District Code           Physical Address of Rental Unit on 12/31/2023             Unit              City/Town of Rental Unit on 12/31/2023 and  State

      Federal                                                                                                 Will you be using Renter Credit 
     Filing Status           Single               Married/CU      Married/CU                   Head of        to pay Income Tax liability?       Yes                  No
                                                  Filing Jointly  Filing Separately            Household
                                                                                                                                                                                 27 - 27
  1.  SPAN     .  To find your SPAN, please see instructions. .................................               1.  ______________________________________- -
To determine eligibility, answer questions 2 through 4.
  2.  Were you domiciled in Vermont all of calendar year 2023?  .......2.                      Yes, Go to Question 3.             No, STOP.  You are not eligible.

  3.  Were you claimed as a dependent by another taxpayer in 2023?  ...3.                      Yes, STOP.  You are not eligible.  No, Go to Question 4.

  4.  Did you rent in Vermont for six months or more in 2023?  ........4.                      Yes, Go to Question 5.             No, STOP.  You are not eligible.
If you are eligible for a Renter Credit, complete Lines 5 through 14.
  5.  Did you share your rental unit with another adult who was not your jointly filed spouse? .......................                     5.    Yes                           No

  6.  Was your rent subsidized?  ........................................................................                                  6.    Yes                           No

                   6a.   If “Yes”, how many months was your rent subsidized in 2023? ..............................               6a.  ___________________

  7.  Number of months rented in 2023  ..................................................................                                  7.  ___________________
  8.  Number of Personal Exemptions claimed (from Form IN-111, Line 5d) 
      (See the instructions if you did not file Form IN-111) ...................................................                           8.  ___________________

  9.  Did you file a federal income tax return?  (See the instructions if you answered “No.”)  ........................                    9.    Yes                           No

 10.  Total Income (from federal Form 1040, Line 9) .......................................................                       10.  _______________ .00
 11.  75% of nontaxable Social Security benefits  
      (from federal Form 1040, Line 6a minus Line 6b.  Multiply result by 0.75) .................................                 11.  _______________ .00

 12.  Tax-exempt interest (from federal Form 1040, Line 2a) ................................................                      12.  _______________ .00
 13.  Add back any negative amounts from federal Form 1040, Line 7 and Schedule 1, Lines 3, 4, 5, 6, and 8a. 
      (See instructions)  ..............................................................................                          13.  _______________ .00

 14.  Total (ADD Lines 10 through 13) .................................................................                           14.  _______________ .00
  Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, 
  correct, and complete. Preparers cannot use return information for purposes other than preparing returns.
   Signature                                                                                               Date (MM/DD/YYYY)               Daytime Telephone Number
                                                                                                              /             /
   Signature (If a joint return, BOTH must sign.)                                                          Date (MM/DD/YYYY)               Daytime Telephone Number              FORM  (Place at LAST page)
                                                                                                              /             /                                                    Form pages 
   Paid Preparer’s Signature                                                                               Date (MM/DD/YYYY)               Preparer’s Telephone Number
                                                                                                              /             /
   Firm’s Name (or yours if self-employed) and address                                                     Preparer’s SSN or PTIN          FEIN 

                                                                                                                                           Form RCC-146                          27 - 27
                     5454                 Check if the Department of Taxes may discuss this return with the preparer shown.       Page 1 of 1, Rev. 10/23

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