Federal Extension
Were you granted an automatic extension to le your 2020 federal income tax return (Form 1040)?
IMPORTANT: Do not send a photocopy of this form.
Staple All Pages of Your Return Here
Staple W-2s Here
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:
Deceased Taxpayer Information
Fill in circle if return is led and signed by Executor,
Administrator, or Court-Appointed Personal Representative.
Taxpayer
(MM-DD-YY)
Enter date of death of deceased taxpayer or deceased spouse.
Was your spouse a resident for the entire year?
If No, complete and attach
Form D-400 Schedule PN.
Residency Status
Were you a resident of N.C. for the entire year?
Fill in circle if you, or if married ling jointly, your spouse were out of the country on April 15, 2021, and a U.S. citizen or resident.
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.)
2020 Individual
Income Tax Return
D-400
AMENDED RETURN
Fill in circle (See instructions)
Single
1.
Filing Status
(Fill in one circle only)
Yes No
Yes No
Yes No
Is your spouse a veteran?
Yes No
Veteran Information
Are you a veteran?
You must enter your
social security number(s)
Enter Whole U.S. Dollars Only
6.
6. Federal Adjusted Gross Income
7.
7. Additions to Federal Adjusted Gross Income
(From Form D-400 Schedule S, Part A, Line 17)
9.
9. Deductions From Federal Adjusted Gross Income
(From Form D-400 Schedule S, Part B, Line 34)
8. Add Lines 6 and 7 8.
10.
13.
Part-year Residents and Nonresidents Taxable Percentage
(From Form D-400 Schedule PN, Line 24. Enter amount as decimal.)
13.
14.
North Carolina Taxable Income
Full-year residents enter the amount from Line 12b.
Part-year residents and nonresidents multiply amount on Line 12b by
the decimal amount on Line 13.
14.
15.
15.
North Carolina Income Tax
Multiply Line 14 by 5.25% (0.0525). If zero or less, enter a zero.
(Fill in one circle only. See Form D-400 Schedule A.)
11.
11. N.C. Standard Deduction OR N.C. Itemized Deductions
10b.
Child Deduction (On Line 10a, enter the number of qualifying
children for whom you were allowed a federal child tax credit. On Line
10b, enter the amount of the child deduction. See instructions.)
10a.
a. Add Lines 9,
10b, and 11.
12.
12b. Subtract the
amount on Line
12a from Line 8.
Yes No
DOR Use Only
Web-Fill
9-20
For calendar year 2020, or scal year beginning and ending (MM-DD-YY)
(MM-DD)
2 0
Your Social Security Number Spouse’s Social Security Number
Mailing Address
Spouse’s Last Name
Your Last NameYour First Name
(USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
M.I.
If a Joint Return, Spouse’s First Name M.I.
Apartment Number
Zip Code
Country (If not U.S.)
City State County
(Enter rst ve letters)
Spouse
(MM-DD-YY)
Out of Country
OTHER THAN YOUR SIGNATURE, DO NOT HANDWRITE ON THIS FORM
CLEAR
4
PRINT
OTHER THAN YOUR SIGNATURE, DO NOT HANDWRITE ON THIS FORM
I declare and certify that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete.
Add Lines 29 through 3233. 33.
Subtract Line 33 from Line 28. This is the Amount To Be Refunded
For direct deposit, le electronically
34.
34.
19. Add Lines 17 and 18
19.
18. Consumer Use Tax (See instructions)
If you certify that no Consumer
Use Tax is due, ll in circle.
18.
Subtract Line 16 from Line 1517. 17.
Other Tax Payments21. a. 2020 estimated tax
c. Partnership
20.
a. Your tax withheld
b. Spouse’s tax withheld
North Carolina
Income Tax Withheld
Total Due - Add Lines 26a, 26d, and 26e
Pay in U.S. Currency from a Domestic Bank - You can pay
online at www.ncdor.gov.
27.
27.
$
Overpayment - If Line 19 is less than Line 25,
subtract Line 19 from Line 25.
28.
28.
30. Contribution to the N.C. Nongame and Endangered Wildlife Fund
30.
Amount of Line 28 to be applied to 2021 Estimated Income Tax29.
29.
26e.
a. Tax Due - If Line 19 is more than Line 25, subtract Line 25 from Line 19.
Otherwise, go to Line 28.
26.
26a.
26d.
(Add Lines 26b
and 26c and
enter the total
on Line 26d.)
b. Penalties c. Interest
Exception to
Underpayment
of Estimated
Tax
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. 31.
Subtract Line 24 from Line 23. (If less than zero, see instructions.)25. 25.
Amended Returns Only - Previous refunds (See “Amended Returns” in instructions)24.
24.
Total Payments - Add Lines 20a through 2223.
Amended Returns Only - Previous payments (See “Amended Returns” in instructions)22.
23.
22.
When ling an amended return, see instructions.
Contribution to the N.C. Breast and Cervical Cancer Control Program32. 32.
If REFUND, mail return to: N.C. DEPT. OF REVENUE, P.O. BOX R, RALEIGH, NC 27634-0001
If you ARE NOT due a refund, mail return, any payment, and D-400V to: N.C. DEPT. OF REVENUE, P.O. BOX 25000, RALEIGH, NC 27640-0640
Contact Phone Number
(Include area code)
Check here if you authorize the North Carolina Department of Revenue to
discuss this return and attachments with the paid preparer below.
Y o u r S i g n a t u r e
Date
Spouse’s Signature (If ling joint return, both must sign.) Date
Paid Preparer’s Signature
Date
If prepared by a person other than taxpayer, this certication is based on all
information of which the preparer has any knowledge.
Preparer’s FEIN, SSN, or PTIN Preparer’s Contact Phone Number (Include area code)
PAID
PREPARER
USE ONLY
16. Tax Credits (From Form D-400TC, Part 3, Line 19)
16.
Page 2
D-400 Web-Fill
9-20
Last Name (First 10 Characters)
Your Social Security Number
2020
Tax Year
b. Paid with extension
d. S Corporation
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.