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
OTHER THAN YOUR SIGNATURE, DO NOT HANDWRITE ON THIS FORM