IMPORTANT: Do not send a photocopy of this form.
The original form is printed in pink and black ink.
Staple W-2s Here
Enter Whole U.S. Dollars Only
6. Federal adjusted gross income
(Form 1040, Line 37; Form 1040A, Line 21; or Form
1040EZ, Line 4) (If negative, see the Line instructions)
Fill in one circle only. (See instructions on Page 8)
(Enter your spouse’s
full name and Social
Married Filing Jointly
Married Filing Separately
Head of Household
Qualifying Widow(er) with Dependent Child (Year spouse died:
7. Additions to federal adjusted gross income
(From Part A of Form D-400 Schedule S, Line 4;
attach Schedule S if additions are reported.)
9. Deductions from federal adjusted gross income
(From Part B of Form D-400 Schedule S, Line 12;
attach Schedule S if deductions are reported.)
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.
Enter date of death of deceased taxpayer or deceased spouse.
If No, complete Lines 1 through 12. Then go to
Part D of Schedule S. Fill in residency information
and complete Lines 20 through 22.
Was your spouse a resident for the entire year?
Were you a resident of N.C. for the entire year of 2014?
Fill in circle if you or your spouse were out of the country on April 15 and a U.S. citizen or resident.
Subtract Line 11 from Line 1012.
11. N.C. standard deduction OR itemized deductions (See instructions on Page 8)
If itemizing, complete Part C of Form
D-400 Schedule S and enter the amount
from Line 19; attach Schedule S.
Part-year residents and nonresidents
(From Part D of Form D-400 Schedule S, Line 22;
attach Schedule S if a part-year resident or nonresident)
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
15. North Carolina Income Tax
To calculate your tax, multiply your North Carolina Taxable Income
Line 14 by 5.8% (0.058)
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 28. See instructions for information about the Fund.
If you claimed the standard
deduction on federal
form 1040, ll in circle
Tax Return 2014
Your Social Security Number Spouse’s Social Security Number
For calendar year 2014, or scal year beginning (MM-DD-YY) and ending (MM-DD-YY)
You must enter your
social security number(s)
Staple All Pages of Your Return Here
Spouse’s Last Name
Your Last NameYour First Name
(USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
If a Joint Return, Spouse’s First Name M.I.
Mailing Address Apartment Number
Country (If not U.S.)
City State County
(Enter rst ve letters)
Taxpayer (MM-DD-YY) Spouse (MM-DD-YY)