Find more court forms on the Vermont Judiciary website.
Forms
Forms
Advance Directive Forms
Send this form and your Advance Directive to the Vermont Advance Directive Registry to store it electronically so hospitals or other providers have quick access to it in an emergency.
Use this form to create an Advance Directive for your health care. It is 11 pages long.
Use this text or the fillable PDF form below the text.
Use this form to create an Advance Directive for your health care. It is three pages long. Use this text or the fillable PDF form below the text.
Complaint Forms
If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don't have to pay.
Use this form to file a complaint with the Vermont Human Rights Commission if you or your child has experienced discrimination at your child's school.
Use this form to file a consumer complaint in Vermont, for example if a debt collector does something they're not supposed to.
Fill out this form if you have been discriminated against at work in Vermont.
If you are an applicant or employee at the State of Vermont, use this employment discrimination form.
If you think your health information privacy rights have been violated, you can file a complaint with the U.S. Department of Health and Human Services.
If you believe that your health information privacy rights have been violated by the Vermont Agency of Human Services, you can file a complaint.
To file a housing discrimination complaint with the Vermont Human Rights Commission, fill in this form.
HUD (the U.S. Department of Housing and Urban Development) handles violations of federal housing law, including discrimination violations.
Use this form to file a complaint about your insurance company with the Department of Financial Regulation.
If you have a complaint about a medical provider other than a doctor, physician's assistant or podiatrist, use this form.
Use this form to file a complaint about a doctor, physician's assistant or podiatrist.
If you have a wage or pay problem with your employer, use this Vermont Department of Labor (DOL) form to ask for help.
Debt Collection Forms
If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don't have to pay.
Use this form to file a consumer complaint in Vermont, for example if a debt collector does something they're not supposed to.
Use this form letter to tell debt collectors to stop calling you.
Disaster Forms
The SBA provides low interest disaster loans. Businesses can apply if they suffered physical property damage or economic injury, even if not located in the disaster area.
Use this form to amend last year's return. For example, use this form if you are claiming a loss for the previous year due to a natural disaster.
To request an IRS account transcript (computer printout), use this form. You can also use the short form, 4506T-EZ.
To request copies of tax returns, complete this form. Copies of past tax returns are free for people affected by a federally declared disaster area.
This is the short form version of Form 4506-T. Use this form to ask for a free tax transcript. It can be used in the foreclosure mediation process.
To calculate and report casualty losses, such as after a natural disaster, you will need to complete this form.
If you have a new address, complete this form to notify the IRS. Updating your address with the post office does not update it with the IRS.
Family Forms
If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don't have to pay.
Use this link to apply for these Vermont programs: 3SquaresVT, Fuel Assistance, Reach Up and Essential Person.
Use this form to file a complaint with the Vermont Human Rights Commission if you or your child has experienced discrimination at your child's school.
Use this form to file for legal separation in Vermont if you and your spouse do not have children.
Use this form to file for legal separation if you and your spouse have children.
Use this form to order a civil union dissolution certificate from the Department of Health.
Use this form when you are going through a divorce in the state of Vermont.
Use this form if you are the defendant in a divorce case in Vermont and don't have children.
Use this form if you are the defendant in a divorce case in Vermont and have children.
Use this income and expense affidavit when filing for divorce in the state of Vermont.
Use this property and asset affidavit when filing for divorce in the state of Vermont.
HUD (the U.S. Department of Housing and Urban Development) handles violations of federal housing law, including discrimination violations.
Use this form to initiate a Motion to Modify to change your child custody order.
If you ask someone to stop coming into your home but the person keeps coming anyway, you can use a Notice Against Trespass to keep the person out.
If you are the defendant in a divorce case and have no children, file either a Notice of Appearance or Answer and Counterclaim within 21 days of being served with the court papers.
Prepare a motion to enforce your child support order in the state of Vermont.
Prepare a motion to modify (change) your child support order in the state of Vermont.
Use this form when you are filing for non-resident divorce or dissolution of a civil union.
An affidavit is a sworn statement. The Relief from Abuse Affidavit is filed with your request for a Relief from Abuse Order.
This form is used to give a sworn statement about what happened to cause you to file a Relief from Abuse Complaint on behalf of a child.
A Relief from Abuse Order is a court order that tells your abuser they can't abuse you anymore. To get one, file this form and a Relief from Abuse Affidavit.
This form is used to ask for a Relief from Abuse Order on behalf of a minor child. This form must be filed with the Relief From Abuse Affidavit on Behalf of a Child.
Respond to a divorce, civil union dissolution or legal separation complaint from your partner.
Start a divorce, civil union dissolution or legal separation in the state of Vermont.
Foreclosure Forms
If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don't have to pay.
Complete this form if you receive a foreclosure Complaint. You must file a written Answer within 21 calendar days of when you received the Complaint.
If you are a tenant and your landlord is being foreclosed on, use this form to enter an appearance in the foreclosure case and to get notices about the foreclosure case.
This is the short form version of Form 4506-T. Use this form to ask for a free tax transcript. It can be used in the foreclosure mediation process.
Medicaid Forms
To apply for Medicaid for the Aged, Blind and Disabled & Medicaid for the Working Disabled (MABD).
If Vermont Medicaid tells you that it does not cover a service you need, you can ask for Medicaid to make an exception and cover the service.
If you only need to apply for prescription help in Vermont, use the 201P application.
Medicare Forms
Use this form to allow Medicare to give your personal health information to someone other than you.
If you only need to apply for prescription help in Vermont, use the 201P application.
Power of Attorney Forms
Use this form to give someone Power of Attorney for your financial affairs. This means that this person is allowed to help you manage your money and property.
Prescription Drug Forms
If you only need to apply for prescription help in Vermont, use the 201P application.
Public Benefits Forms
Use this form to apply to the Green Mountain Power Energy Assistance Program for help providing electricity to your home.
Use this form to apply to the Vermont Gas Energy Assistance Program for help providing gas to your home.
If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don't have to pay.
Use this link to apply for these Vermont programs: 3SquaresVT, Fuel Assistance, Reach Up and Essential Person.
You can request a fair hearing if your request was denied or approved at less than you asked for, or if your amount goes down or stops.
Do you have medical expenses? Do you have a disability or are you over 60? Should you get more food stamps?
You have the right to appeal decisions from the Department for Children and Families (DCF) about your benefits. Use this form to appeal.
Use this form letter to ask for a hearing if someone refuses to give you rent assistance or if your rent assistance or Section 8 is being stopped.
Use this form to apply for housing/rental assistance in Burlington.
If your Reach Up grant recently went down (decreased), you can appeal with this Form Letter.
To find out if you’re eligible for Fuel Assistance to help pay for your home heating bills, fill out this application.
If you only need to apply for prescription help in Vermont, use the 201P application.
You First is a health program for Vermont women with a low income.
Relief from Abuse
If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don't have to pay.
An affidavit is a sworn statement. The Relief from Abuse Affidavit is filed with your request for a Relief from Abuse Order.
This form is used to give a sworn statement about what happened to cause you to file a Relief from Abuse Complaint on behalf of a child.
A Relief from Abuse Order is a court order that tells your abuser they can't abuse you anymore. To get one, file this form and a Relief from Abuse Affidavit.
This form is used to ask for a Relief from Abuse Order on behalf of a minor child. This form must be filed with the Relief From Abuse Affidavit on Behalf of a Child.
Renter (Tenant) / Landlord
Use this form to apply to the Green Mountain Power Energy Assistance Program for help providing electricity to your home.
Use this form to apply to the Vermont Gas Energy Assistance Program for help providing gas to your home.
If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don't have to pay.
Use this link to apply for these Vermont programs: 3SquaresVT, Fuel Assistance, Reach Up and Essential Person.
When a person’s disabilities prevent them from using or enjoying their housing in the same way as people without disabilities, they can ask for reasonable changes in their housing.
Use this Answer form when the landlord is trying to evict you. Generally, a tenant/defendant must file an Answer 21 days after the day the Complaint was served.
If you are a tenant and your landlord is being foreclosed on, use this form to enter an appearance in the foreclosure case and to get notices about the foreclosure case.
Use this form letter to ask for a hearing if someone refuses to give you rent assistance or if your rent assistance or Section 8 is being stopped.
To file a housing discrimination complaint with the Vermont Human Rights Commission, fill in this form.
HUD (the U.S. Department of Housing and Urban Development) handles violations of federal housing law, including discrimination violations.
Use this letter to let your landlord know about the law about coming into your apartment.
In most kinds of subsidized housing, you can ask for your rent to be recalculated if your income drops. We have created a form letter that you can use.
If you ask someone to stop coming into your home but the person keeps coming anyway, you can use a Notice Against Trespass to keep the person out.
Use this form to apply for housing/rental assistance in Burlington.
Use this form letter to tell your landlord about repairs needed at your home.
Use this letter to tell your landlord you have defects in your rental unit that materially affect health and safety.
Use this form letter to ask your landlord to return your security deposit.
To find out if you’re eligible for Fuel Assistance to help pay for your home heating bills, fill out this application.
Your landlord has to give you this form by January 31 (if your apartment/house has more than one rented unit) or a reasonable amount of time after you ask for it (if there's only one unit).
Use these forms from the Vermont Department of Taxes to claim the renter rebate.
Small Claims Forms
If you cannot afford a court filing fee, use this form. The clerk may be able to waive the fee for you so you don't have to pay.
Use this form to file a request for the court to order the other party in a small claims case to give you and the court more information about their financial situation.
Use this form to fill out Small Claims Financial Disclosure paperwork to tell the court about your financial situation.
Use this form to give the court your contact information. Send them a new form if something changes. The court can then send you copies of any notices, court dates and paperwork filed in court.
Use this form to respond to (answer) a small claims complaint that someone filed against you.
Tax Forms
Use this form to amend last year's return. For example, use this form if you are claiming a loss for the previous year due to a natural disaster.
To request an IRS account transcript (computer printout), use this form. You can also use the short form, 4506T-EZ.
To request copies of tax returns, complete this form. Copies of past tax returns are free for people affected by a federally declared disaster area.
This is the short form version of Form 4506-T. Use this form to ask for a free tax transcript. It can be used in the foreclosure mediation process.
If you have a new address, complete this form to notify the IRS. Updating your address with the post office does not update it with the IRS.
Instructions and online forms to file your federal income tax return for free.
This set of forms is used to tell the state of Vermont that you live in the house you own (homestead declaration) and to ask for help paying your property taxes (property tax credit claim).
Your landlord has to give you this form by January 31 (if your apartment/house has more than one rented unit) or a reasonable amount of time after you ask for it (if there's only one unit).
Use these forms from the Vermont Department of Taxes to claim the renter rebate.
Updated: Sep 25, 2020
