Instructions For Form Nc-5x, Amended Withholding Return - Formupack
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1Instructions for Form NC-5X, Amended Withholding Return
Use Form NC-5X to amend a previously filed Withholding Return, Form NC-5.
Indicate the period covered by the return in the blocks provided. Enter the legal name, Account ID, and
Federal Employer Identification Number (FEIN) or Social Security Number (SSN). Use capital letters when
entering legal name and address.
Line 1 - Tax Withheld as Corrected: Enter the corrected North Carolina income tax required to be withheld.
Line 2 - Enter the tax withheld as originally reported or previously adjusted.
Line 3 - If Line 2 is more than Line 1, subtract and enter the overpayment. You will receive a refund if there
is an overpayment on Line 3.
Line 4 - If Line 1 is more than Line 2, subtract and enter the additional tax due.
Line 5 - If additional tax is due, enter the accrued interest. The interest rate is set semiannually by the
Secretary of Revenue and is published on the Department’s website at
Line 6 - Enter the total amount due and payable. (Add Lines 4 and 5)
Please do not fold, staple, tape, or paper clip the return or payment.
Use blue or black ink to complete your return.
Make check payable in U.S. currency to N.C. Department of Revenue.
Cut return on line below and mail it with your payment to the address on the return.
!
!
Cut Here
Amended Withholding Return
You will receive a refund if you have
an overpayment on Line 3.
North Carolina Department of Revenue
Period Beginning (MM-DD-YY)
Period Ending (MM-DD-YY)
,
,
.
1.
Tax Withheld
00
as Corrected
2.
Tax Withheld as Originally
,
,
.
Account ID
FEIN or SSN
Reported or Previously
00
Adjusted
.
,
,
3.
Overpayment
USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS
(If Line 2 is more than Line 1,
00
subtract and enter Overpayment)
Legal Name (First 23 Characters)
.
,
,
4.
Additional Tax Due
(If Line 1 is more than Line 2,
00
subtract and enter Tax Due)
Street Address
,
,
.
00
5.
Interest
City
State
Zip Code (5 Digit)
,
,
.
$
6.
Total Tax Due
00
(Add Lines 4 and 5)
Signature:
Date:
I certify that, to the best of my knowledge, this return is accurate and complete.
NC-5X
(
)
Title:
Phone:
11-01
MAIL TO: P.O. Box 25000, Raleigh, NC 27640-0615
Web
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