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Forms

Find more court forms, tips and instructions in the various sections of our website (Family, Money/Debt, etc.). Also find all Vermont court forms on the Vermont Judiciary website.

VTCourtForms

We’ve created a new tool that helps Vermonters fill out some court forms. We continue to add to our collection of VTCourtForms, but at this time you can:

Forms

Advance Directive Forms

Adding an Advance Directive to the Registry
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.
Advance Directive for Health Care - Long Form
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.  
Advance Directive for Health Care - Short Form
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

Complaint About Discrimination in School
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.
Consumer Complaint
Use this form to file a consumer complaint in Vermont, for example if a debt collector does something they're not supposed to.
Employment Discrimination Complaint Form
Fill out this form if you have been discriminated against at work in Vermont.  
Employment Discrimination Form for State of Vermont Employees
If you are an applicant or employee at the State of Vermont, use this employment discrimination form.
Federal Trade Commission Complaint Form
Use this form to file a complaint with the FTC.  
Health Information Privacy Complaint 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.
Health Information Privacy Complaint Involving AHS Form
If you believe that your health information privacy rights have been violated by the Vermont Agency of Human Services, you can file a complaint.
Housing Discrimination Complaint Form for Vermont Human Rights Commission
To file a housing discrimination complaint with the Vermont Human Rights Commission, fill in this form.
HUD Federal Housing Law Discrimination Complaint
HUD (the U.S. Department of Housing and Urban Development) handles violations of federal housing law, including discrimination violations.
Insurance Complaint Form
Use this form to file a complaint about your insurance company with the Department of Financial Regulation.
Office of Professional Regulation Complaint Form
If you have a complaint about a medical provider other than a doctor, physician's assistant or podiatrist, use this form.
Vermont Board of Medical Practice Complaint Form
Use this form to file a complaint about a doctor, physician's assistant or podiatrist.
Wage Claim Form
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

Application to Waive Filing Fees and Service Costs
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.
Certificate of Service
This form is filed with the court to confirm that you sent court documents to the other party in a case. Be sure to find out what kind of service is required for your kind of court case.
Consumer Complaint
Use this form to file a consumer complaint in Vermont, for example if a debt collector does something they're not supposed to.
Stop Debt Collection Calls and Exempt Income letter
Use this form letter to tell debt collectors to stop calling you. 

Disaster Forms

IRS Form 1040X: Amended US Individual Income Tax Return
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.  
IRS Form 4506-T: Request for Transcript of Tax Return
To request an IRS account transcript (computer printout), use this form. You can also use the short form, 4506T-EZ.
IRS Form 4506: Request for Copy of Tax Return
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.
IRS Form 4506T-EZ: Request for Individual Tax Return Transcript
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.
IRS Form 4684: Casualties and Thefts
To calculate and report casualty losses, such as after a natural disaster, you will need to complete this form.  
IRS Form 8822: Change of Address
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

Application to Waive Filing Fees and Service Costs
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.
Apply for Public Benefits
Use this link to apply for these Vermont programs: 3SquaresVT, Fuel Assistance, Reach Up and Essential Person.
Certificate of Service
This form is filed with the court to confirm that you sent court documents to the other party in a case. Be sure to find out what kind of service is required for your kind of court case.
Complaint About Discrimination in School
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.
Form 813A - Financial Affidavit
Use this income and expense affidavit when filing for divorce in the state of Vermont.  
Form 813B - Financial Affidavit
Use this property and asset affidavit when filing for divorce in the state of Vermont.  
Inventory for an Estate in Probate
Fill out an inventory for an estate in probate court.  
Notice Against Trespass
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.
Notice of Appearance
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.
Open an Estate in Probate
Fill out the paperwork you need to open an estate in probate court, when someone has died.
Parentage Complaint or Answer
Use the Summons and Complaint form if you want to start a parentage action. If you receive a Summons and Complaint, you need to send in the Answer within 21 days.
Prepare a Motion to Enforce Child Support
Prepare a motion to enforce your child support order in the state of Vermont.  
Prepare a Motion to Modify Child Custody Order
Ask the court to change your child custody or visitation order.
Prepare a Motion to Modify Child Support
Ask the court to modify (change) your child support order in the state of Vermont.  
Relief from Abuse Complaint & Affidavit
Learn how to get a Relief from Abuse (RFA) order and get the forms to use in our RFA Roadmap.
Respond to a Divorce, Civil Union Dissolution or Legal Separation
Respond to a divorce, civil union dissolution or legal separation Complaint from your partner by using an Answer form.
Start a Divorce, Civil Union Dissolution or Legal Separation
Get the forms you need to start a divorce, civil union dissolution or legal separation in Vermont.

Foreclosure Forms

Application to Waive Filing Fees and Service Costs
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.
Certificate of Service
This form is filed with the court to confirm that you sent court documents to the other party in a case. Be sure to find out what kind of service is required for your kind of court case.
Foreclosure Answer Form
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.
IRS Form 4506T-EZ: Request for Individual Tax Return Transcript
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.
Request for Information Letter for Mortgage Assistance
Before you can get mortgage assistance payments through the Vermont COVID Emergency Mortgage Assistance Program, VHFA will need to talk to your mortgage servicer about your mortgage debt. Use this sample letter.

Medicaid Forms

Medicaid 205ALLMED Application
To apply for Medicaid for the Aged, Blind and Disabled (MABD) & Medicaid for the Working Disabled.
Vermont Medicaid Coverage Exception Request
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.
Vermont Pharmacy Programs Application (VPharm)
If you only need to apply for prescription help in Vermont, use the 201P application.

Medicare Forms

Medicare Authorization to Disclose Personal Health Information Form
Use this form to allow Medicare to give your personal health information to someone other than you.  
Medicare Savings Programs Application
To apply for Medicare Savings Programs.
Vermont Pharmacy Programs Application (VPharm)
If you only need to apply for prescription help in Vermont, use the 201P application.

Power of Attorney Forms

Form to Revoke Power of Attorney
Use this form to revoke (remove) Power of Attorney from your agent.
Power of Attorney for Financial Affairs Form
A Power of Attorney is a legal document to give another person authority to handle your financial and personal decisions.

Prescription Drug Forms

Vermont Pharmacy Programs Application (VPharm)
If you only need to apply for prescription help in Vermont, use the 201P application.

Probate Court Forms

Certificate of Service
This form is filed with the court to confirm that you sent court documents to the other party in a case. Be sure to find out what kind of service is required for your kind of court case.
Inventory for an Estate in Probate
Fill out an inventory for an estate in probate court.  
Name Change Petition - Adult
Change your name in Vermont.
Open an Estate in Probate
Fill out the paperwork you need to open an estate in probate court, when someone has died.

Public Benefits Forms

Application for Energy Assistance from Green Mountain Power
Apply to the Green Mountain Power Energy Assistance Program for help providing electricity to your home.  
Application for Energy Assistance from Vermont Gas Systems
Apply to the Vermont Gas Energy Assistance Program for help providing gas to your home.  
Application to Waive Filing Fees and Service Costs
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.
Apply for Public Benefits
Use this link to apply for these Vermont programs: 3SquaresVT, Fuel Assistance, Reach Up and Essential Person.
Developmental Disability Services Request for a Fair Hearing
You can use a form to ask for a fair hearing if your request was denied or approved at less than you asked for, or if your amount goes down or stops.  
Form to Appeal Public Benefits Decision
You have the right to appeal decisions from the Department for Children and Families (DCF) about your benefits.  Use this form to appeal.
Housing Appeal Letter
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.
Preliminary Application for Housing/Rental Assistance in Burlington
Use this form to apply for housing/rental assistance in Burlington.  
Reach Up Grant Decrease Appeal Form Letter
If your Reach Up grant recently went down (decreased), you can appeal with this Form Letter.  
Vermont Fuel Assistance Application
To find out if you’re eligible for Fuel Assistance to help pay for your home heating bills, fill out this application.
Vermont Pharmacy Programs Application (VPharm)
If you only need to apply for prescription help in Vermont, use the 201P application.
You First Health Program Application
You First is a health program for Vermont women with a low income.

Relief from Abuse

Relief from Abuse Complaint & Affidavit
Learn how to get a Relief from Abuse (RFA) order and get the forms to use in our RFA Roadmap.

Renter (Tenant) / Landlord

Application for Energy Assistance from Green Mountain Power
Apply to the Green Mountain Power Energy Assistance Program for help providing electricity to your home.  
Application for Energy Assistance from Vermont Gas Systems
Apply to the Vermont Gas Energy Assistance Program for help providing gas to your home.  
Application to Waive Filing Fees and Service Costs
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.
Apply for Public Benefits
Use this link to apply for these Vermont programs: 3SquaresVT, Fuel Assistance, Reach Up and Essential Person.
Certificate of Service
This form is filed with the court to confirm that you sent court documents to the other party in a case. Be sure to find out what kind of service is required for your kind of court case.
Disability - Request for Reasonable Accommodations or Modifications in Your Housing
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.
Eviction Answer Form
Use this Answer form when the landlord is trying to evict you. Generally, a tenant/defendant must file an Answer within 21 days after the day the Complaint was served.
Eviction Counterclaims Form
Use this counterclaims form during the eviction process, if needed.
Housing Appeal Letter
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.
Housing Discrimination Complaint Form for Vermont Human Rights Commission
To file a housing discrimination complaint with the Vermont Human Rights Commission, fill in this form.
HUD Federal Housing Law Discrimination Complaint
HUD (the U.S. Department of Housing and Urban Development) handles violations of federal housing law, including discrimination violations.
Letter to Landlord about Access
Use this letter to let your landlord know about the law about coming into your apartment.
Letter to Report Change in Income to Subsidized Housing
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.
Notice Against Trespass
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.
Preliminary Application for Housing/Rental Assistance in Burlington
Use this form to apply for housing/rental assistance in Burlington.  
Repair and Withholding Letter to Landlord
Use this letter to tell your landlord you have defects in your rental unit that materially affect health and safety. 
Repair Letter to Landlord
Use this form letter to tell your landlord about repairs needed at your home.
Security Deposit Return Letter
Use this form letter to ask your landlord to return your security deposit.
Vermont Fuel Assistance Application
To find out if you’re eligible for Fuel Assistance to help pay for your home heating bills, fill out this application.
VT Renter Credit / Renter Rebate Claim
Use form RCC-146 from the Vermont Department of Taxes to claim the renter credit, formerly called the renter rebate.

Small Claims Forms

Application to Waive Filing Fees and Service Costs
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.
Ask the Court to Order Financial Disclosure
In a small claims case, use this form to ask the court to order the other party to give you and the court more information about their financial situation.
Certificate of Service
This form is filed with the court to confirm that you sent court documents to the other party in a case. Be sure to find out what kind of service is required for your kind of court case.
Fill Out Financial Disclosure Paperwork
Use this form to fill out Small Claims Financial Disclosure paperwork to tell the court about your financial situation.  
Notice of Appearance
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.
Respond to a Small Claims Complaint / Small Claims Answer Form
Use this form to respond to (answer) a small claims complaint that someone filed against you.  
Start a Small Claims Case / Small Claims Complaint Form
File a Small Claims Complaint in Vermont.  

Tax Forms

IRS Form 1040X: Amended US Individual Income Tax Return
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.  
IRS Form 4506-T: Request for Transcript of Tax Return
To request an IRS account transcript (computer printout), use this form. You can also use the short form, 4506T-EZ.
IRS Form 4506: Request for Copy of Tax Return
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.
IRS Form 4506T-EZ: Request for Individual Tax Return Transcript
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.
IRS Form 8822: Change of Address
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.
IRS Free File Fillable Forms
Instructions and online forms to file your federal income tax return for free.  
IRS Tax Forms
Links to all IRS tax forms and their instructions.
VT Homestead Declaration and Property Tax Credit Claim: Forms HS-122 and HI-144
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).
VT Income Tax Forms
Links to all income tax forms for individuals and their instructions.  
VT Renter Credit / Renter Rebate Claim
Use form RCC-146 from the Vermont Department of Taxes to claim the renter credit, formerly called the renter rebate.
Updated: Nov 01, 2024