![]() Enlarge image | Vermont Department of Taxes 133 State Street Montpelier, VT 05633-1401 Phone: (802) 828-6851 VT Form VERMONT LAND GAINS *191771100* WITHHOLDING TAX RETURN *191771100* LGT-177 To be completed by Transferee (Buyer) Page 5 A. TRANSFEROR’S (Seller’s) INFORMATION Entity TRANSFEROR Name Federal ID Number OR Individual TRANSFEROR Last Name First Name Initial OR Social Security Number TRANSFEROR Mailing Address Following Transfer Daytime Telephone Number Line 2 for Mailing Address Following Transfer (if needed) For Department Use Only City State ZIP Code Foreign Country (if not United States) Email Address FORM (Place at FIRST page) Form pages B. TRANSFEREE’S (Buyer’s) INFORMATION Entity TRANSFEREE Name Federal ID Number OR Individual TRANSFEREE Last Name First Name Initial OR Social Security Number 5 - 6 TRANSFEREE Mailing Address Following Transfer Daytime Telephone Number Line 2 for Mailing Address Following Transfer (if needed) For Department Use Only City State ZIP Code Foreign Country (if not United States) Email Address C. PROPERTY INFORMATION Property Physical Location - Number and Street or Road Name Land Size (in acres) City or Town Check if property is located SPAN in multiple cities or towns D. HOLDING PERIOD Date Acquired by Transferor (mm dd yyyy) Date of this Closing (mm dd yyyy) Time Held _________ Years _________ Months (continued on next page) Form LGT-177 Page 1 of 2 5454 Rev. 12/19 |
![]() Enlarge image | Transferee’s Name _____________________________________________________ Property Location _____________________________________________________ Date of this Closing ____________________________________________________ *191771200* *191771200* Page 6 E. EXEMPTIONS E1. If transfer is exempt from Land Gains Tax, enter exemption number . . . . . . . . . . E1. ___________________________ E1a. If Line E1 is “08,” enter description . . . . . . . . . . . . . . . . E1a. _________________________________________ E2. If a Vermont Commissioner’s Certificate issued, enter Certificate number . . . . . . E2. ___________________________ E3. Is the transferor simultaneously filing a Form LGT-178 and paying the full amount of tax due? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E3. Yes No F. TAX CALCULATIONS If Lines E1, E2, or E3 do not apply, then: F1. Sales price attributable to land . (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F1. ___________________________ FORM (Place at LAST page) OR Form pages F2. Amount of Installment Sale payment subject to withholding . . . . . . . . . . . . . . . . . F2. ___________________________ F3. Withholding tax rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F3. ________________________10.00 % F4. TAX DUE (Multiply Line F1 or Line F2 by Line F3) . . . . . . . . . . . . . . . . . . . . . . F4. ___________________________ 5 - 6 • If a Commissioner’s Certificate was issued, enter the withholding amount required. • If simultaneously filing a Transferor (Seller) Form LGT-178, enter the amount shown due . • If an exemption is claimed on Line E1, enter -0- (or, if over allowable acreage, enter the amount shown due from Form LGT-178). G. SIGNATURES We hereby certify this return is true, correct, and complete to the best of our knowledge. Signature of Primary Transferee Printed name Date May the Department of Taxes discuss this return with the preparer shown? c Yes c No Preparer’s Date signature Preparer’s Preparer’s Telephone Number printed name Preparer’s ( ) Firm’s name (or if self-employed, your name) and address Use Only Preparer’s email address Send completed return to: Vermont Department of Taxes 133 State Street Montpelier, VT 05633-1401 Form LGT-177 Page 2 of 2 5454 Rev. 12/19 Clear ALL fields Save and go to Important Printing Instructions Save and Print |