1998
NORTH CAROLINA DEPARTMENT OF REVENUE
FORM
APPLICATION FOR AUTOMATIC SIX -- MONTH EXTENSION
D--410
OF TIME TO FILE STATE INCOME AND/OR GIFT TAX RETURNS
(REV. 10--98)
(See back for filing instructions. Be sure to complete all items.)
Your first name and initial (If other than individual, enter complete name on this line)
Last Name
Your social security number
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Spouse’ s social security number
If joint return, spouse’ s first name and initial
Last Name
Please
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Type
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or
Present home address
Federal Employer Identification No.
Print
City, town or post office, state, and zip code
County
Important
File this form with the North Carolina Department of Revenue, P. O. Box 25000, Raleigh, N. C. 27640--0640 by the
:
due date for filing your return. This is not an extension of time to pay your tax.
I hereby apply for an automatic extension of time until October 15, 1999 in which to file the following tax return(s) for calendar year
1998 (or if a fiscal year return, an extension to __________________________________, 19__________, for the tax year beginning
_________________________________,19_________ and ending _____________________________, 19_________).
Individual, Form D--400
Partnership, Form D--403
Estates and Trusts, Form D--407
Gift, Form G--600
If this form is being filed only to extend the time for filing a gift tax return, Form G--600, skip lines 1 through 3 and
Note:
complete lines 4 and 5.
Total income tax liability for 1998. This is the amount you expect to enter on line 12 of Form D--400;
1.
1
00
line 10 of Form D--403; or line 8 of Form D--407. If you do not expect to owe tax, enter zero (--0--) . . . . .
Caution:
You MUST enter an amount on line 1 or your extension will be denied. You can estimate
this amount, but be as exact as you can with the information you have.
If we later find
that your estimate was not reasonable, the extension will be null and void.
2
00
2. Total payments for 1998 (See the instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.
Balance Due (Subtract line 2 from line 1.) If line 2 is more than line 1, enter zero (--0--) . . . . . . . . . . . . . . .
00
3
(FOR GIFT TAX ONLY)
Only complete line 4 and line 5a (and 5b if applicable) if you are applying for an extension of time to
file a gift tax return. Do not include income tax on these lines. (See the instructions.)
4.
If you or your spouse expect to file a gift tax return (Form G--600) for 1998,
Yourself . .
generally due by April 15, 1999, see the instructions and check here . . . . . . .
Spouse . .
5a
00
5a.
Enter the amount of gift tax that you are paying with this form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Enter the amount of gift tax that your spouse is paying with this form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
00
b.
5b
Signature and Verification
I certify that, to the best of my knowledge, this return is accurate and complete.
Signature of taxpayer
Date
Signature of spouse
Date
(If filing jointly, BOTH must sign even if only one had income)
Signature of preparer
Date
other than taxpayer