Vermont Vermont Land Gains Withholding Tax Return To Be Completed By Buyer (Transferee)

Vermont Land Gains Withholding Tax Return To Be Completed By Buyer (Transferee)
Form LGT-177
Vermont Department of Taxes
Phone: (802) 828-6851

VT Form

LGT-177
A.	

133 State Street

Montpelier, VT 05633-1401

*191771100*

VERMONT LAND GAINS
WITHHOLDING TAX RETURN

* 1 9 1 7 7 1 1 0 0 *

To be completed by Transferee (Buyer)

TRANSFEROR’S (Seller’s) INFORMATION
Entity TRANSFEROR Name			

OR

Individual TRANSFEROR Last Name	

First Name	

Federal ID Number	
Initial

OR

TRANSFEROR Mailing Address Following Transfer			

Daytime Telephone Number

For Department Use Only

Line 2 for Mailing Address Following Transfer (if needed)
City	

State	

Foreign Country (if not United States)	

Email Address

B.	

ZIP Code

TRANSFEREE’S (Buyer’s) INFORMATION
Entity TRANSFEREE Name			

OR

Individual TRANSFEREE Last Name	

First Name	

Federal ID Number	
Initial

OR

TRANSFEREE Mailing Address Following Transfer			

Social Security Number

Daytime Telephone Number

For Department Use Only

Line 2 for Mailing Address Following Transfer (if needed)
City	

State	

Foreign Country (if not United States)	

Email Address

C.	

Social Security Number

ZIP Code

PROPERTY INFORMATION

Property Physical Location - Number and Street or Road Name			

Land Size (in acres)

City or Town	
	

SPAN

D.	

Check if property is located 	
in multiple cities or towns

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

5454

Page 1 of 2
Rev. 12/19

Transferee’s Name______________________________________________________
Property Location______________________________________________________
Date of this Closing_____________________________________________________

*191771200*
* 1 9 1 7 7 1 2 0 0 *

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
Yes
No
full amount of tax due?.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . E3.

F.	

TAX CALCULATIONS

If Lines E1, E2, or E3 do not apply, then:
F1.	 Sales price attributable to land.
(see instructions).  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . F1. ____________________________

	

		
OR
	

F2.	 Amount of Installment Sale payment subject to withholding.  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . F2. ____________________________

	

F3.	 Withholding tax rate .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . F3. _________________________

	
	
	
	

F4.	 TAX DUE (Multiply Line F1 or Line F2 by Line F3).  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . F4. ____________________________
•	 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.	

10.00 %

SIGNATURES

We hereby certify this return is true, correct, and complete to the best of our knowledge.
Signature of Primary Transferee

Printed name

May the Department of Taxes discuss this return with the preparer shown?	

Preparer’s
Use Only

Date

c Yes	

c No

Preparer’s
signature

Date

Preparer’s
printed name

Preparer’s Telephone Number
(

)

Firm’s name (or if self-employed, your name) and address
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
Rev. 12/19

5454

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