Form D-400x-Ws - Worksheet For Amending A 2011 Individual Income Tax Return
Download a blank fillable Form D-400x-Ws - Worksheet For Amending A 2011 Individual Income Tax Return in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form D-400x-Ws - Worksheet For Amending A 2011 Individual Income Tax Return with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5
6
7
84
Worksheet for Amending a 2011
D-400X-WS
Individual Income Tax Return
Web-Fill
PRINT
CLEAR
10-11
North Carolina Department of Revenue
IMPORTANT: Do not send a photocopy of this form.
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
Address
Apartment Number
City
State
Zip Code
County
Country (If not U.S.)
(Enter first five letters)
Is the address shown above different than the address shown on your original return?
Yes
No
Fill in applicable circles:
Original return for this tax year has been previously audited
Change of Filing Status (Note: You cannot change from joint to separate returns after the due date of the original return has passed.)
Amended to report Net Operating Loss (Include a copy of your federal Form 1045, including Schedules A & B.)
Amended to report federal change
A. Original
B. Amended
Amended for other reasons
(or as previously adjusted)
Enter the amounts from your amended
D-400 on Lines 1 through 9 of Column B.
Reconciliation Statement
Enter the amounts from your original D-400 on
The amended D-400 must be attached to
Lines 1 through 9 of Column A.
pages 1 and 2 of this form.
1. Enter the income tax from D-400, Line 14
1.
1.
2. Enter tax credits from D-400, Line 15
2.
2.
3. Subtract Line 2 from Line 1
3.
3.
4. Consumer Use Tax from D-400, Line 17
4.
4.
5.
5.
5. Add Line 3 and 4
6. NC Tax Withheld - a. Your tax withheld
6a.
6a.
6b.
6b.
b. Spouse’s tax withheld
7. Other tax payments (Estimated Tax, Payment
7.
7.
with Extension, Partnership, S-Corporation)
8. NC Earned Income Tax Credit from D-400, Line 21
8.
8.
9. Tax Credit for Small Businesses That Pay NC
9.
9.
Unemployment Insurance from D-400, Line 22
10. Amount paid with original return plus additional tax paid after return was filed
10.
11. Total payments. Add Lines 6a through 10 in Column B
11.
12. Total of all previous refunds received or expected to be received for this taxable year
12.
(Do not include any interest you received on any refund.) (See Page 2 of this form.)
13. Subtract Line 12 from Line 11
13.
If Line 13 is more than Line 5, Column B, skip Line 14 and complete Line 17 below
14.
Tax Due If Line 13 is not negative and is less than Line 5, Column B, subtract Line 13 from Line 5, Column B
14.
If Line 13 is negative, treat Line 13 as a positive number and add it to Line 5, Column B
15. Penalties and interest (See Page 2 of this form and Page 6 of Form D-401 instructions.)
15.
$
16. Add Lines 14 and 15 and enter the total due - Pay This Amount
16.
17. If Line 5, Column B is less than Line 13, enter the difference as Amount to Be Refunded
17.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial