Form D-400 - Individual Income Tax Return - 2013

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D-400
Individual Income
Web-Fill
Tax Return 2013
9-13
North Carolina Department of Revenue
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
(USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
M.I.
Your Last Name
If a Joint Return, Spouse’s First Name
M.I.
Spouse’s Last Name
Mailing Address
Apartment Number
Country (If not U.S.)
City
State
Zip Code
County
(Enter first five letters)
Fill in circle if you or your spouse were out of the country on April 15 and a U.S. citizen or resident.
Deceased Taxpayer Information
Fill in circle if return is filed and signed by Executor, Administrator or Court-Appointed Personal Representative.
Taxpayer
Spouse
(MM-DD-YY)
(MM-DD-YY)
If return is for a deceased taxpayer or deceased spouse, enter date of death.
Residency Status
Were you a resident of N.C. for the entire year of 2013?
Yes
No
If No, complete Lines 1 through 15. Then go to Page 4 of Form D-400.
Was your spouse a resident for the entire year?
Fill in residency information and complete Lines 53 through 55.
Yes
No
Filing Status
Fill in one circle only. (See instructions on Page 7)
Enter the Number
of Exemptions
1.
Single
claimed on your
federal income
2.
Married Filing Jointly
tax return
Name
(Enter your spouse’s
3.
Married Filing Separately
full name and Social
Security Number)
SSN
4.
Head of Household
5.
Qualifying Widow(er) with Dependent Child
)
(Year spouse died:
Enter Whole U.S. Dollars Only
6. Federal adjusted gross income
(Form 1040, Line 37; Form 1040A, Line 21; or Form
6.
1040EZ, Line 4) (If negative, see the Line instructions)
7. Additions to federal adjusted gross income
7.
(If applicable, complete Lines 34 through 39 on Page 3
and enter amount from Line 39)
8. Add Lines 6 and 7
8.
9. Deductions from federal adjusted gross income
(If applicable, complete Lines 40 through 52 on Page 3
9.
and enter amount from Line 52)
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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