Fillable 2017 D-400 Webfill 0 (North Carolina)

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2017 D-400 Webfill 0 (North Carolina)

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The 2017 D-400 Webfill 0 (North Carolina) form is 3 pages long and contains:

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IMPORTANT: Do not send a photocopy of this form.
For calendar year 2017, or scal year beginning and ending (MM-DD-YY)
(MM-DD-YY)
Staple All Pages of Your Return Here
Staple W-2s Here
6. Federal adjusted gross income
Filing Status
Married Filing Jointly
2.
SSN
Name
(Enter your spouse’s
full name and Social
Security Number)
Married Filing Separately
3.
Head of Household
4.
5.
Qualifying Widow(er) (Year spouse died:
)
7. Additions to federal adjusted gross income
(From Form D-400 Schedule S, Part A, Line 6)
9. Deductions from federal adjusted gross income
(From Form D-400 Schedule S, Part B, Line 14)
8. Add Lines 6 and 7
10. Subtract Line 9 from Line 8
Deceased Taxpayer Information
Fill in circle if return is led and signed by Executor,
Administrator or Court-Appointed Personal Representative.
Was your spouse a resident for the entire year?
If No, you must complete and attach
Form D-400 Schedule PN.
Residency Status
Were you a resident of N.C. for the entire year of 2017?
Fill in circle if you or, if married ling jointly, your spouse were out of the country on April 15 and a U.S. citizen or resident.
Subtract Line 11 from Line 1012.
Part-year residents and nonresidents taxable percentage
(From Form D-400 Schedule PN, Line 24. Enter amount as decimal)
13.
North Carolina Taxable Income
Full-year residents enter the amount from Line 12.
Part-year residents and nonresidents multiply amount on Line 12 by
the decimal amount on Line 13.
14.
15. North Carolina Income Tax
To calculate your tax, multiply Line 14 by 5.499% (0.05499). If Line 14
is negative, enter -0- on Line 15.
N.C. Education Endowment Fund: You may contribute to the N.C. Education Endowment Fund by making a contribution or designating some or
all of your overpayment to the Fund. To make a contribution, enclose Form NC-EDU and your payment of $ ______________________________.
To designate your overpayment to the Fund, enter the amount of your designation on Page 2, Line 31. See instructions for information about the Fund.
Individual Income
Tax Return 2017
D-400
AMENDED RETURN
Fill in circle (See instructions)
11. N.C. standard deduction OR N.C. itemized deductions
(Fill in one circle only. See Form D-400 Schedule S, Part C.)
Did you claim the standard deduction on your 2017 federal return?
Single
1.
(Fill in one circle only)
Is your spouse a veteran?
Yes No
Yes No
Yes No
Yes No
Yes No
Veteran Information
Are you a veteran?
(See Instructions)
You must enter your
social security number(s)
Web-Fill
11-17
Your Social Security Number Spouse’s Social Security Number
(USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
Mailing Address
Spouse’s Last Name
Your Last NameYour First Name M.I.
If a Joint Return, Spouse’s First Name M.I.
Zip Code
Country (If not U.S.)
City State County
(Enter rst ve letters)
Apartment Number
Spouse
(MM-DD-YY)
Enter date of death of deceased taxpayer or deceased spouse.
Taxpayer
(MM-DD-YY)
Enter Whole U.S. Dollars Only
6.
7.
9.
8.
10.
12.
11.
13.
15.
14.
OTHER THAN YOUR SIGNATURE, DO NOT HAND WRITE ON THIS FORM
4
PRINT
✖
CLEAR
OTHER THAN YOUR SIGNATURE, DO NOT HAND WRITE ON THIS FORM
Page 2
D-400 Web-Fill
11-17
Last Name (First 10 Characters)
Your Social Security Number
2017
Tax Year
Home Telephone Number
(Include area code)
N.C. DEPT. OF REVENUE
P.O. BOX 25000
RALEIGH, NC 27640-0640
If you ARE NOT due a
refund, mail return, any
payment, and D-400V to:
If REFUND mail
return to:
N.C. DEPT. OF REVENUE
P.O. BOX R
RALEIGH, NC 27634-0001
I certify that, to the best of my knowledge, this return is accurate and complete.
Sign Here
If prepared by a person other than taxpayer, this certication is based on all
information of which the preparer has any knowledge.
Y o u r S i g n a t u r e
Spouse’s Signature (If ling joint return, both must sign.) Date
Date
Paid Preparer’s Signature
Preparer’s FEIN, SSN, or PTIN
Date
Preparer’s Telephone Number
(Include area code)
Add Lines 29 through 3233.
Subtract Line 33 from Line 28. This is the Amount To Be Refunded.
For direct deposit, le electronically.
34.
19. Add Lines 17 and 18
18. Consumer Use Tax (See instructions)
If you certify that no Consumer
Use Tax is due, ll in circle.
Subtract Line 16 from Line 1517.
16. Tax Credits (From Form D-400TC, Part 3, Line 20)
Other Tax Payments21. a. 2017 estimated tax
c. Partnership
20. North Carolina
Income Tax Withheld
FOR ORIGINAL RETURNS ONLY
Add Lines 26a, 26d, and 26e
Pay This Amount - You can pay online. See instructions.
27.
Overpayment - If Line 19 is less than Line 25,
subtract Line 19 from Line 25.
28.
30. Contribution to the N.C. Nongame and Endangered Wildlife Fund
Amount of Line 28 to be applied to 2018 Estimated Income Tax29.
a. Tax Due - If Line 19 is more than Line 25, subtract Line 25 from Line 19.
(If Line 25 is negative, see instructions.)
26.
(Add Lines 26b
and 26c and
enter the total
on Line 26d.)
b. Penalties
e. Interest on the underpayment of estimated income tax
(See instructions and enter letter in box, if applicable.)
Contribution to the N.C. Education Endowment Fund31.
Subtract Line 24 from Line 2325.
Amended Returns Only - Previous refunds (See “Amended Returns” in instructions)24.
Total Payments - Add Lines 20a through 2223.
Amended Returns Only - Previous payments (See “Amended Returns” in instructions)22.
When ling an amended return, see instructions.
Contribution to the N.C. Breast and Cervical Cancer Control Program32.
33.
34.
19.
18.
17.
16.
27.
$
28.
30.
29.
26e.
26a.
26d.
31.
25.
24.
23.
22.
32.
a. Your tax withheld
b. Paid with extension
d. S Corporation
b. Spouse’s tax withheld
If you claim a
partnership payment
on Line 21c or S
corporation payment
on Line 21d, you must
attach a copy of the
NC K-1.
c. Interest
Exception to
underpayment
of estimated
tax
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2017 D-400 Webfill 0 (North Carolina)

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Completed 20 April 2021

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