Vermont Economic Advancement Tax Incentives

Economic Advancement Tax Incentives
Schedule BA-405
Vermont Department of Taxes

Schedule BA-405
Economic Advancement Tax Incentives (EATI)
PRINT in BLUE or BLACK INK
•	 Schedule BA-405 must be filed with the Vermont Business, Corporate, or Individual Income Tax Return for six years following the
end of the EATI authorization period.  For example, if the Vermont Economic Progress Council (VEPC) authorized an award from
January 1, 2000, through December 31, 2004, Schedule BA-405 must be filed with all tax returns from 2005 through 2010.
•	 Send a duplicate of this form to:  Vermont Economic Progress Council, National Life Building, Drawer 20, Montpelier, VT  05620-0501.
Entity Name (Principal Vermont Corporation)			

FEIN	

Primary 6-digit NAICS number

Address			

Tax year BEGIN date (YYYYMMDD)	

Tax year END date (YYYYMMDD)

Address (Line 2)			

Contact Person Name	

Title

City	

Telephone Number	

Fax Number

State	

ZIP Code	

Foreign Country			

Email Address

Location of Project (Street Address or Other Description)

Full-Time Employment Levels in Vermont

Report the average number of full-time employees in Vermont for each quarter of the tax year. For purposes of this form, a full-time employee is
defined as an employee who works no less than 37 hours each week.
1st Quarter

2nd Quarter

3rd Quarter

4th Quarter

	1a.	 Period covered (Months & Year)
	1b.	 Number of full-time Vermont employees
	2.	Report average annual full-time Vermont employment for this tax year
(average of the four quarters above). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2._____________________________
	3a.	 During the first six years after the beginning of the EATI authorization, what was the highest average
annual full-time Vermont employment, using the same calculation method as above?. . . . .  . . . . . . . . . . .  3a._____________________________
			

3b.	In which tax year did this occur?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . . . . . . . . . .  3b._____________________________

	4.	What was the lowest number of full-time employees in Vermont for any period of 120 consecutive days
that ended during this tax year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . . . . . . . . . . .  4._____________________________

If Line 4 is less than 75% of Line 3a, you must notify the Vermont Economic Progress Council within 60 days of the
period of 120 consecutive days. You also must report the recapture on Form IN-111, Vermont Income Tax Return, for
the tax year in which the period of 120 consecutive days occurred. Refer to Vermont law at 32 V.S.A. § 5930h for details.
Signature

Under penalties of perjury, I declare this report and all documents attached in support of this report, are true, correct, and complete
to the best of my knowledge and belief.

Signature of Responsible Officer		

Title	

Printed Name	

Email Address (optional)

Telephone Number	

5454

Date

Schedule BA-405
Rev. 10/20