IMPORTANT: Do not send a photocopy of this form.
The original form is printed in pink and black ink.
Your Social Security Number Spouse’s Social Security Number
For calendar year 2015, or scal year beginning and ending (MM-DD-YY)
You must enter your
social security number(s).
Your Last NameYour First Name
(USE CAPITAL LETTERS FOR YOUR NAME AND ADDRESS)
Staple All Pages of Your Return Here.
Staple W-2s Here.
6. Adjusted gross income from your federal return
(If negative, see instructions.)
(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 Line 4 of Form D-400 Schedule S, Part A)
9. Deductions from federal adjusted gross income
(From Line 12 of Form D-400 Schedule S, Part B)
8. Add Lines 6 and 7. 8.
10. Subtract Line 9 from Line 8. 10.
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.
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 21 through 23.
Were you a resident of N.C. for the entire year of 2015?
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 10.12.
Part-year residents and nonresidents
(From Line 23 of Form D-400 Schedule S, Part D)
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 Line 14 by 5.75% (0.0575). 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.
Tax Return 2015
Fill in circle. (See instructions.)
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 20.)
Did you claim the standard deduction on your 2015 federal return?
Fill in one circle only. (See instructions.)
Enter Whole U.S. Dollars Only
Spouse’s Last NameIf a Joint Return, Spouse’s First Name
Country (If not U.S.)
City State County
(Enter rst ve letters)