Form D-400x-Ws - Worksheet For Amending A 2011 Individual Income Tax Return Page 8
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Your Social Security Number
Last Name (First 10 Characters)
Tax Year
2011
D-400TC Web-Fill
10-11
Part 4. Other Tax Credits (Limited to the amount of tax)
(continued)
21. Credit for long-term care insurance premiums (Complete the Worksheet for Determining Tax
21.
Credit for Premiums Paid on Long-term Care Insurance Contracts on Page 18 of the instructions.)
Do not enter more than $350 per contract.
22.
22. Credit for adoption expenses (Complete the Adoption Tax Credit Worksheet on Page 18 of the instructions.)
23. Credit for children with disabilities who require special education
23.
(See instructions on Page 18.)
24. Credit for Qualified Business Investments (See instructions on Page 18. You must attach a copy of
24.
the tax credit approval letter that you received from the Department of Revenue.)
25. Credit for disabled taxpayer, dependent, or spouse (Complete Form D-429, Worksheet for
25.
Determining the Credit for the Disabled Taxpayer, Dependent, or Spouse, and
enter the amount from Line 13 or 14, whichever is applicable.)
26. Credit for certain real property land donations (See instructions on Page 19.)
26.
Enter expenditures and expenses on Lines 27a, 28a, 29a, and 30a only in the first year the credit is taken
27.
Credit for rehabilitating an income-producing historic structure (See instructions on Page 19.)
Enter installment
Enter qualified
27a.
27b.
amount of credit
rehabilitation expenditures
28.
Credit for rehabilitating a nonincome-producing historic structure (See instructions on Page 19.)
Enter installment
Enter rehabilitation
28a.
28b.
expenses
amount of credit
29.
Credit for rehabilitating an income-producing historic mill facility (See instructions on Page 19.)
Enter qualified
29a.
29b.
Enter amount of credit
rehabilitation expenditures
30.
Credit for rehabilitating a nonincome-producing historic mill facility (See instructions on Page 19.)
Enter installment
Enter rehabilitation
30a.
30b.
amount of credit
expenses
31. Other miscellaneous income tax credits (See instructions on Page 19.)
Fill in applicable circles:
Property Taxes on Farm Machinery
Gleaned Crops
Handicapped Dwelling Units
Poultry Composting
31.
Conservation Tillage Equipment
Recycling Oyster Shells
32.
32.
Tax credits carried over from previous year, if any. Do not include any
carryover of tax credits claimed on Form NC-478.
33.
33. Total (Add Lines 19, 20b, 21, 22, 23, 24, 25, 26, 27b, 28b, 29b, 30b, 31, and 32)
34.
34. Amount of total North Carolina income tax (From Form D-400, Line 14)
35. Enter the lesser of Line 33 or Line 34
35.
36. Business incentive and energy tax credits (See
Fill in circle if
instructions on Page 20. Attach Form NC-478
NC-478 is attached.
36.
and any required supporting schedules to the
Example:
front of your income tax return.)
37.
Add Lines 35 and 36 (Enter the total here and on Form D-400, Line 15.)
37.
The amount on this line may not exceed the tax shown on Form D-400, Line 14.
Part 5. Earned Income Tax Credit (Not limited to the amount of tax)
You are allowed a credit equal to 5% of the Earned Income Tax Credit allowed on your federal return. For part-year residents and nonresidents, the
credit must be prorated based on the ratio of income subject to North Carolina tax to total federal income.
38. Enter the amount of your federal earned income tax credit.
Number of qualifying children
38.
39. Multiply Line 38 by 5% (.05)
39.
Full-year residents enter this amount here and on Line 21 of Form D-400.
40. Part-year residents and nonresidents multiply the amount on Line 39 by the decimal amount from Form
D-400, Line 12 and enter the result here and on Line 21 of Form D-400. If Line 12 of Form D-400 is more
40.
than 1.0000, enter the amount from Line 39 here and on Line 21 of Form D-400.
Part 6. Tax Credit for Small Businesses That Pay N.C. Unemployment Insurance (Not limited to the amount of tax)
41. a. Enter the amount of qualified N.C. Unemployment Insurance Contributions
41a.
b. Multiply Line 41a by 25% (.25) and enter the amount here and on Line 22 of Form D-400
41b.
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