-A A +A

All 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.  
Use this form to create an Advance Directive for your health care.  

Complaint Forms

Use this form to file a complaint with the 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.
Use this form to file a complaint with the FTC.  
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.
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 with the Department of Financial Reguation.
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.
To file a complaint with the Human Rights Commission, fill in this housing complaint form.  

CourtFormPrep

Use this CourtFormPrep 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.
Forms by the Vermont Judiciary.
This CourtFormPrep program will help you fill out the paperwork you need to fill out an inventory for an estate in probate. 
Use this CourtFormPrep form to fill out Small Claims Financial Disclosure paperwork to tell the court about your financial situation.  
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. 
Use this CourtFormPrep form to start a non-resident divorce or civil union dissolution by agreement in the state of Vermont. 
This CourtFormPrep program will help you fill out the paperwork you need to open an estate in Probate. 
Use this CourtFormPrep program to prepare a motion to enforce your child support order in the state of Vermont. 
Use this CourtFormPrep program to prepare a motion to modify (change) your child support order in the state of Vermont. 
Use this CourtFormPrep form to respond to a divorce, civil union dissolution or legal separation complaint from your partner. 
Use this CourtFormPrep form to start a divorce, civil union dissolution or legal separation in the state of Vermont. 
Use this CourtFormPrep form to start a parentage case in the state of Vermont. 
Use this CourtFormPrep form to file a Small Claims Complaint. 

Debt Collection Forms

Use this form to file a consumer complaint in Vermont, for example if a debt collector does something they're not supposed to.  
You can use this form to stop collection agencies from calling you at work. However, the company you owe the money to can still call you.
Using this form letter will only stop the debt collection agency calls. The company you owe the debt to may still call you.
Use this form letter to tell Debt Collectors to stop calling you and tell them that your income is exempt from collection.

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.
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

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 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. 
If you are the defendant in a divorce case and have no children, file either a Notice of Appearance or Answer and Counterclaim within 20 days of being served with the court papers.
Use this form if you are the defendant in a divorce case and have children.
This CourtFormPrep program will help you fill out the paperwork you need to fill out an inventory for an estate in probate. 
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. 
Use this form to initiate a Motion to Modify in order to change your child custody order. 
HUD (the U.S. Department of Housing and Urban Development) handles violations of federal housing law, including discrimination violations.
If you cannot afford the court filing fee, bring this form with you to the courthouse. The clerk may be able to waive the fee for you so you don't have to pay.
Use this CourtFormPrep form to start a non-resident divorce or civil union dissolution by agreement in the state of Vermont. 
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 20 days of being served with the court papers.
This CourtFormPrep program will help you fill out the paperwork you need to open an estate in Probate. 
Use this CourtFormPrep program to prepare a motion to enforce your child support order in the state of Vermont. 
Use this CourtFormPrep program to 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.
Use this CourtFormPrep form to respond to a divorce, civil union dissolution or legal separation complaint from your partner. 
Use this CourtFormPrep form to start a divorce, civil union dissolution or legal separation in the state of Vermont. 
Use this CourtFormPrep form to start a parentage case in the state of Vermont. 

Foreclosure Forms

Complete this form if you receive a foreclosure Complaint. You must file a written Answer within 20 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.  
Use this form to request foreclosure mediation.  
If you cannot afford the court filing fee, bring this form with you to the courthouse. The clerk may be able to waive the fee for you so you don't have to pay.
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.

Guardianship Forms

Use this form to ask for the appointment of a guardian for an adult.  
Use this form to initiate a voluntary guardianship for yourself if you are an adult.  

Medicaid Forms

If you are requesting a Medicaid Coverage Exception, you will need to fill out this form.
If you are requesting a Medicaid Coverage Exception, give your provider the "10 standards" list and the Provider Request Form.  
If you are applying only for Prescription Assistance, use this form. If you are applying for other medical programs as well, apply online through DCF. 

Medical Marijuana Registry Forms

To become registered as a Medical Marijuana Caregiver in the state of Vermont, you must complete this form.
To become listed on the Medical Marijuana Registry in the State of Vermont, both this form and the Patient Form must be completed.
To become listed on the Medical Marijuana Registry in the State of Vermont, both this form and the Health Care Professional Verification Form must be completed.

Medicare Forms

This form is used to say who can represent you when dealing with Medicare.  
Use this form to allow Medicare to give your personal health information to someone other than you.  
Use this form for a first-level Medicare appeal.  
Use this form for a second-level Medicare appeal.  
Use this form for a third-level Medicare appeal to request a hearing by an Administrative Law Judge.  
Use this form for a fourth-level Medicare appeal to request a review of the Administrative Law Judge's decision/dismissal.  
Use this form to request a Medicare prescription drug coverage determination.  
Use this form to request medical payment from Medicare.  
If you are applying only for Prescription Assistance, use this form. If you are applying for other medical programs as well, apply online through DCF. 

Power of Attorney Forms

Use this form to revoke (remove) Power of Attorney from your agent.  
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

Use this form for a first-level Medicare appeal.  
Use this form for a second-level Medicare appeal.  
Use this form for a third-level Medicare appeal to request a hearing by an Administrative Law Judge.  
Use this form for a fourth-level Medicare appeal to request a review of the Administrative Law Judge's decision/dismissal.  
Use this form to request a Medicare prescription drug coverage determination.  
If you are applying only for Prescription Assistance, use this form. If you are applying for other medical programs as well, apply online through DCF. 

Public Benefits Forms

If you disagree with the Social Security Administration's decision, use this letter to ask for a hearing.  
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.  
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.
Ladies First is a program for Vermont women with a low income and no health insurance, or with limited income and an abnormal Pap test or breast symptoms. Use this form to apply. 
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 developmental disability request was denied or was approved at less than you asked for, or if your dev.
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 to ask for a hearing if someone refuses to give you rent assistance or if your rent assistance or Section 8 is being stopped.  
If you cannot afford the court filing fee, bring this form with you to the courthouse. The clerk may be able to waive the fee for you so you don't have to pay.
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.  
If you are applying only for Prescription Assistance, use this form. If you are applying for other medical programs as well, apply online through DCF. 
To find out if you’re eligible for Seasonal Fuel Assistance, fill out this application. Then the Seasonal Fuel Program will send you a notice in the mail that says if you are eligible.

Relief from Abuse

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.  
Use this link to apply for these Vermont programs: 3SquaresVT, Fuel Assistance, Reach Up and Essential Person.
Use this form to answer what your landlord claims about you if your landlord is trying to evict you.  
Use this form to file a counterclaim against your landlord during the eviction process.  
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 to ask for a hearing if someone refuses to give you rent assistance or if your rent assistance or Section 8 is being stopped.  
HUD (the U.S. Department of Housing and Urban Development) handles violations of federal housing law, including discrimination violations.
If you cannot afford the court filing fee, bring this form with you to the courthouse. The clerk may be able to waive the fee for you so you don't have to pay.
Use this letter to let your landlord know about the law about coming into your apartment.   
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.  
You can print this form letter, fill in the information about the repairs needed at your home, and send it to your landlord.
If it's been 14 days since you told your landlord you moved out or you believe your landlord wrongfully kept your security deposit, use this form to ask your landlord to return it.
To file a complaint with the Human Rights Commission, fill in this housing complaint form.  
To find out if you’re eligible for Seasonal Fuel Assistance, fill out this application. Then the Seasonal Fuel Program will send you a notice in the mail that says if you are eligible.
Your landlord has to give you this form by 1/31 (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

Use this CourtFormPrep 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 CourtFormPrep form to fill out Small Claims Financial Disclosure paperwork to tell the court about your financial situation.  
If you cannot afford the court filing fee, bring this form with you to the courthouse. The clerk may be able to waive the fee for you so you don't have to pay.
This is a notice of appearance for probate court (such as small claims). Defendants: Use this form to ask the court to 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.  
This form is for disclosing (telling the court about) your finances in a small claims case.  
Use this CourtFormPrep form to file a Small Claims Complaint. 

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.
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.
Instructions and online forms to file your federal income tax return.  
Links to all IRS tax forms and their instructions.
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 adjustment claim).
Your landlord has to give you this form by 1/31 (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.  
Links to all Vermont tax forms and their instructions.