D-400x - Amended North Carolina Individual Income Tax Return
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Amended North Carolina
D-400X
Web-Fill
Individual Income Tax Return
7-06
PRINT
CLEAR
This return is for taxable year
If changes to this return are applicable to your federal return, include a copy of Federal Form 1040X.
Your first name and middle initial
Your last name
Your Social Security No.
If a joint return, spouse’s first name and middle initial
Spouse’s last name
Spouse’s Social Security No.
Address
Daytime Telephone Number
City, town or post office, state and zip code
County
Office Use Only
Enter below name and address shown on original return if different from
Has your original return for this taxable year
name and address shown above
Yes
No
been changed or audited?
If “No,” have you been notified that it will be?
Yes
No
Filing status claimed. Note: You cannot change from joint to separate returns after the due date of the original return has passed.
On original return
Single
Married filing joint return
Married filing separate return
Head of household
Qualifying widow(er)
On this return
Single
Married filing joint return
Married filing separate return
Head of household
Qualifying widow(er)
Correction of Taxable Income and Tax Payments
A. As originally reported
B. Net change - Increase
C. Correct Amount
or as previously adjusted
or Decrease - explain on
(See instructions on page 2)
(see instructions)
page 2
1.
Taxable income from your federal income tax return
1.
2.
Additions to federal taxable income
2.
3.
Add lines 1 and 2
3.
4.
Deductions from federal taxable income
4.
5.
Line 3 minus line 4
5.
(Taxable percentage
6.
North Carolina taxable income
6a.
6.
as corrected)
7.
North Carolina income tax
(Use Tax Rate Schedule on reverse)
7.
Tax Credits
8.
(Attach Form D-400TC if changing tax credits claimed previously)
8.
9.
Line 7 minus line 8
9.
10.
Consumer Use Tax
(If applicable)
10.
11.
Add lines 9 and 10
11.
12a.
a. Your tax withheld
12.
North Carolina income tax withheld
12b.
b. Spouse’s tax withheld
13.
Other tax payments
13.
14.
Amount paid with original return plus additional tax paid after it was filed
14.
15.
Total payments. Add lines 12a through 14 in column C
15.
Total of all previous refunds received for this taxable year
16.
16.
17.
Line 15 minus line 16
17.
18.
If line 11, column C is more than line 17, enter the difference here
18.
19.
Interest due (See instructions)
19.
20.
Add lines 18 and 19 and enter the total - Pay This Amount
20.
21.
If line 11, column C is less than line 17, enter the difference as Amount To Be Refunded
21.
I certify that, to the best of my knowledge, this return is accurate and complete.
If prepared by a person other than taxpayer, this certification is based on all
information of which the preparer has any knowledge.
Sign
Your Signature
Date
Paid Preparer’s Signature
Date
Here
Spouse’s Signature (If filing joint return, both must sign)
Date
Paid Preparer’s FEIN, SSN, or PTIN
Preparer’s Telephone Number
N.C. DEPT. OF REVENUE, P.O. BOX 25000, RALEIGH, NC 27640-0640
Mail to:
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