Form D-407 - Estates And Trusts Income Tax Return - 2016 Page 2
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Legal Name (First 10 Characters)
Federal Employer ID Number
D-407
Web-Fill
9-16
Estate Information:
Trust Information:
Date Trust Created
Date of Decedent’s Death
Name and Address
of Grantor
If no return filed last year,
reason why
If no return filed last year,
reason why
Schedule A. North Carolina Fiduciary Adjustments (See instructions)
1. Interest income from obligations of states other than North Carolina
1.
2. State, local, or foreign income taxes deducted on the federal return
2.
3. Adjustment for bonus depreciation (See instructions)
3.
4. Other additions to income (See instructions)
4.
Total additions to income (Add lines 1, 2, 3, and 4)
5.
5.
Apportion the additions on Line 5 between the beneficiaries and the fiduciary on Schedule B, Line 4 below
6. Interest income from obligations of the United States or United States’ possessions
6.
7. Taxable portion of Social Security and Railroad Retirement benefits
7.
8. Retirement benefits received from vested N. C. State government, N. C. local government,
8.
or federal government retirees (Bailey Settlement – Important: See Instructions)
9. State, local, or foreign income tax refunds reported as income on federal return
9.
10. Adjustment for bonus depreciation added back in 2011, 2012, 2013, 2014, and 2015
10a. 2011
10b. 2012
10c. 2013
10d. 2014
10e. 2015
(Add Lines 10a, 10b, 10c, 10d, and 10e, and enter total on Line 10f)
10f.
11. Other deductions from income (See instructions)
11.
12. Total deductions from income (Add Lines 6, 7, 8, 9, 10f, and 11)
12.
Apportion the deductions on Line 12 between the beneficiaries and the fiduciary on Schedule B, Line 5 below
Important: If more than three beneficiaries, include separate
Schedule B. Apportionment of Income and Adjustments
(See instructions)
schedule for additional beneficiaries.
Fiduciary
Beneficiary 1
Beneficiary 2
Beneficiary 3
Attach other pages if needed.
1.
Identifying Number
2.
Name
3.
Net N.C.
Source Income
4.
Additions
5.
Deductions
Important:
The fiduciary must provide each beneficiary an NC K-1 for Form D-407 or other information necessary for the beneficiary to prepare
the appropriate North Carolina Income Tax Return.
I certify that, to the best of my knowledge, this return is accurate and complete.
If prepared by a person other than fiduciary, this certification is based on all information
of which the preparer has any knowledge.
Signature of Fiduciary Representing Estate or Trust
Date
Signature of Preparer Other Than Fiduciary
Date
Address
Daytime Telephone Number (Include area code)
Preparer’s Daytime Telephone Number (Include area code)
MAIL TO: NC Department of Revenue, P.O. Box 25000, Raleigh, NC 27640-0640
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