Form D-400x - Amended North Carolina Individual Income Tax Return - 2013
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Amended North Carolina
D-400X
Web-Fill
PRINT
CLEAR
Individual Income Tax Return 2013
12-13
North Carolina Department of Revenue
Print in Black or Blue Ink
IMPORTANT: Do not send
a photocopy of this form.
Only. No Pencil or Red Ink.
For calendar year 2013, or fiscal year beginning
and ending
(MM-DD-YY)
(MM-DD-YY)
Your Social Security Number
Spouse’s Social Security Number
You must enter your
social security number(s)
Your First Name
M.I.
Your Last Name
(USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
If a Joint Return, Spouse’s First Name
M.I.
Spouse’s Last Name
Mailing Address
Apartment Number
City
State
Zip Code
County
Country (If not U.S.)
(Enter first five letters)
Deceased Taxpayer Information
Reason for Amending Your Return
(Fill in the circle for all applicable boxes; see instructions)
Original return has been previously audited by the Department
Fill in circle if return is filed and signed by Executor,
Administrator or Court-Appointed Personal Representative.
Federal audit change
Important
Filing Status
You must complete the entire form
Taxpayer
(MM-DD-YY)
Claim of right
including the explanation
If return is for
of changes section on Page 4.
a deceased
Treaties
taxpayer or
Protective claim
deceased
Spouse
spouse, enter
(MM-DD-YY)
Net operating loss (Include copy of your federal form 1045, including Schedules A & B)
date of death.
Tax credits (Attach Form D-400TC)
Other
Were you a resident of N.C. for the entire year of 2013?
Yes
No
Residency
If No, complete Lines 1 through 15. Then go to Page 4 of Form D-400X.
Status
Was your spouse a resident for the entire year?
Fill in residency information and complete Lines 52 through 54.
Yes
No
Filing Status
Fill in one circle only. (See instructions on Page 7)
Enter the Number of
1.
Single
Exemptions claimed
on your federal
2.
Married Filing Jointly
income tax return
Name
(Enter your spouse’s
3.
Married Filing Separately
full name and Social
Security Number)
4.
Head of Household
SSN
5.
Qualifying Widow(er) with Dependent Child
)
(Year spouse died:
6. Federal adjusted gross income
Enter Whole U.S. Dollars Only
(Form 1040, Line 37; Form 1040A, Line 21;
or Form 1040EZ, Line 4; or Form 1040X, Line 1)
6.
(If negative, see the Line instructions)
7. Additions to federal adjusted gross income
7.
(If applicable, complete Lines 33 through 38 on Page 3
and enter amount from Line 38)
8. Add Lines 6 and 7
8.
9. Deductions from federal adjusted gross income
(If applicable, complete Lines 39 through 51 on Page 3
9.
and enter amount from Line 51)
10. Subtract Line 9 from Line 8
10.
11.
N.C. standard deduction
OR
N.C. itemized deductions
11.
IMPORTANT: Do not enter the amount from your federal return.
(You must fill in appropriate circle. See instructions on Pages 7, 8, and 9)
12.
12.
Subtract Line 11 from Line 10
13.
N.C. personal exemption allowance (See instructions on Page 9)
13.
14.
Subtract Line 13 from Line 12
14.
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