Fillable D-400 Individual Income Tax Return 2016 AMENDED RETURN (North Carolina)

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D-400 Individual Income Tax Return 2016 AMENDED RETURN (North Carolina)

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The D-400 Individual Income Tax Return 2016 AMENDED RETURN (North Carolina) form is 2 pages long and contains:

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  • 21 check-boxes
  • 65 other fields

Country of origin: US
File type: PDF

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Staple All Pages of Your Return Here.
AMENDED RETURN
Fill in circle. (See instructions.)
Individual Income
Tax Return 2016
D-400
Web-Fill
8-16
IMPORTANT: Do not send a photocopy of this form.
Your Social Security Number Spouse’s Social Security Number
For calendar year 2016, or scal year beginning and ending (MM-DD-YY)
(MM-DD-YY)
You must enter your
social security number(s).
Your Last NameYour First Name
(USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
M.I.
M.I.
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.
Qualifying Widow(er) with Dependent Child
(Year spouse died:
)
5.
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 Lines 1 through 12. Then go to
Part D of Schedule S. Fill in residency information
and complete Lines 24 through 26.
Yes No
Yes No
Residency Status
Were you a resident of N.C. for the entire year of 2016?
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.
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.
Did you claim the standard deduction on your 2016 federal return?
Single
1.
Fill in one circle only. (See instructions.)
Yes No
Enter Whole U.S. Dollars Only
Mailing Address
Spouse’s Last NameIf a Joint Return, Spouse’s First Name
Apartment Number
Zip Code
Country (If not U.S.)
City State County
(Enter rst ve letters)
Spouse
(MM-DD-YY)
13.
Part-year residents and nonresidents
(From Line 26 of Form D-400 Schedule S, Part D)
13.
6.
6. Adjusted gross income from your federal return
(If negative, see instructions.)
7.
7. Additions to federal adjusted gross income
(From Line 6 of Form D-400 Schedule S, Part A)
9.
9. Deductions from federal adjusted gross income
(From Line 14 of Form D-400 Schedule S, Part B)
8. Add Lines 6 and 7. 8.
10. Subtract Line 9 from Line 8. 10.
12.
Subtract Line 11 from Line 10.12.
11.
11. N.C. standard deduction OR N.C. itemized deductions
Fill in one circle only. (If itemizing, complete Part C of Form D-400
Schedule S, and enter the amount from Line 23.)
14.
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.
15. North Carolina Income Tax
To calculate your tax, multiply Line 14 by 5.75% (0.0575). If Line 14 is
negative, enter -0- on Line 15.
Filing Status
Is your spouse a veteran?
Veteran Information
Are you a veteran?
(See Instructions.)
Yes No
Yes No
4
PRINT
✖
CLEAR
Page 2
D-400 Web-Fill
8-16
Last Name (First 10 Characters)
Your Social Security Number
2016
Tax Year
Be sure to sign and date your return below.
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
Home Telephone Number (Include area code.)
Date
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
Paid Preparer’s Signature
Preparer’s Telephone Number (Include area code.)
Preparer’s FEIN, SSN, or PTIN
Date
Add Lines 26a, 26d, and 26e.
Pay This Amount - You can pay online. See instructions.
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 2017 Estimated Income Tax29.
29.
Contribution of overpayment to the N.C. Education Endowment Fund31. 31.
Add Lines 29, 30, and 31.32. 32.
Subtract Line 32 from Line 28. This is the Amount To Be Refunded.
For direct deposit, le electronically.
33.
33.
26e.
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.
26a.
26d.
(Add Lines 26b
and 26c and
enter the total
on Line 26d.)
b. Penalties c. Interest
e. Interest on the underpayment of estimated income tax
(See instructions and enter letter in box, if applicable.)
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 15.17.
17.
16. Tax Credits (From Form D-400TC, Part 3, Line 20 - You must attach
Form D-400TC if you enter an amount on this line.)
16.
Subtract Line 24 from Line 23.25.
25.
Amended Returns Only - Previous refunds (See Amended Returns in instructions.)24.
24.
Other Tax Payments21. a. 2016 estimated tax
b. Paid with extension
c. Partnership
d. S Corporation
Total Payments - Add Lines 20a through 22.23.
20.
a. Your tax withheld
b. Spouse’s tax withheld
North Carolina
Income Tax Withheld
Amended Returns Only - Previous payments (See Amended Returns in instructions.)22.
23.
22.
FOR ORIGINAL RETURNS ONLY
When ling an amended return, see instructions.
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.
Exception to
underpayment
of estimated
tax
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D-400 Individual Income Tax Return 2016 AMENDED RETURN (North Carolina)

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Completed 20 April 2021

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