Prepared For:
UNCW STUDENT
01/30/2013
Today's Savings
*
In simple terms, the Marginal Tax Rate is the tax rate that you pay on your last dollar of taxable
income. It is the highest federal tax bracket that affects your tax calculation. The Effective Tax
Rate is the percentage of your total income that you paid in taxes. For 2012, your Marginal Tax
Rate is 10% and your Effective Tax Rate is 0%.
Total Savings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $0.00
Filing, Refund and Balance Due Information
Tax Return
efile
Refund /
(Balance Due)
Federal
No
($26.00)
Balance Due
North Carolina
No
($272.00)
Balance Due
Summary
Message
($26.00)
See the Filing Checklist for instructions.
($272.00) See the Filing Checklist for mailing instructions.
Th is H &R B lock Ad vant age d ocument provid es inf ormat ion t h at could h elp y ou improve y our t ax and f inancial sit uat ion. It s cont ent s sh ould b e consid ered in conj unct ion w it h
inf ormat ion you receive f rom ot h er sources t h at are f amiliar w it h your specif ic circumst ances. Tax services of f ered t h rough sub sid iaries of H RB Tax Group, Inc.
Advantage (2012)
FDADVICE-1WV 1.0
Form Sof t w are Copyrigh t 1996 - 2013 H RB Tax Group, Inc.
2012 Tax Return Summary
Federal Year over Year Comparison
INCOME
Year 2012
Other income
Total income
Year 2011
Change($)
$10,000
$10,000
$0
$0
$10,000
$10,000
$10,000
$0
$10,000
$5,950
$3,800
$250
$0
$0
$0
$5,950
$3,800
$250
$26
$26
$0
$0
$26
$26
$26
$0
$26
$26
$0
$26
$10,000
10%
Single
$0
$10,000
ADJUSTED GROSS INCOME
Total income less total adjustments
TAXABLE INCOME
Standard deductions
Exemptions
Taxable income
TAX COMPUTATION
Income tax
Tax before credits
OTHER TAXES
Total tax
AMOUNT DUE
Amount owed with return
OTHER COMPUTATIONS
Alternative minimum taxable income
Marginal tax bracket
Filing status
Client Sum (2012)
FDBASUM-1WV 1.0
Form Sof t w are Copyrigh t 1996 - 2013 H RB Tax Group, Inc.
2012 Federal Tax Return Filing Instructions
FOR THE YEAR ENDING
December 31, 2012
UNCW STUDENT
Prepared for
Tax
Summary
Gross Income
Adjusted Gross Income
Total Deductions
Total Taxable Income
Total Tax
Total Payments
Refund Amount
Amount You Owe
Make check
payable to
United States Treasury
Mailing
Address
Internal Revenue Service Center
P.O. Box 931000
Louisville, KY 40293-1000
$
$
$
$
$
$
$
$
10,000
10,000
9,750
250
26
0
0
26
Instructions
STEP 1 - Sign and date Form 1040
STEP 2 - Assemble what you need to mail
Attach any schedules and forms behind Form 1040 in order of the
Attachment Sequence Number shown in the upper right corner of the schedule
or form. If there are supporting statements, arrange them in the same
order as the schedules or forms they support and attach them last. Do not
attach correspondence or other items unless required to do so. Attach
a copy of each W-2, W-2G, and 2439 to the front of Form 1040. Also
attach Form(s) 1099-R or 1099-G if tax was withheld.
STEP 3 - Pay balance due on your taxes
Make your check or money order for $26 payable to the United States
Treasury. Do not send cash and do not forget to sign it. Write your
Social Security number(s) and daytime phone number on your check or
money order (U.S. funds only).
STEP 4 - Mail Form(s)
Mail Form 1040 and associated documents to the address above.
Retain the proof of mailing to avoid a late filing penalty.
We recommend you use one of these methods to send your 1040:
- U.S. Postal Service certified mail.
If you are not mailing to an address with a post office box, you may
also use:
- Federal Express (FedEx): Priority Overnight, Standard Overnight,
2Day, International Priority, or International First
- United Parcel Service (UPS): Next Day Air, Next Day Air Saver,
2nd Day Air, or Worldwide Express
CONTINUED ON NEXT PAGE
Checklist (2012)
FDCHECKE-1WV 1.0
Form Sof t w are Copyrigh t 1996 - 2013 H RB Tax Group, Inc.
UNCW STUDENT
2012 Federal
Filing Instructions Continued
Instructions
STEP 5 - Keep a copy
Print a copy of the return for your records.
Please attach a copy of each W-2, W-2G, 1099G and 1099R to your return.
Checklist (2012)
FDCHECKE-2WV 1.0
Form Sof t w are Copyrigh t 1996 - 2013 H RB Tax Group, Inc.
Form
D epart ment of t h e Treasury - Int ernal Revenue Service
(99)
1040 U.S. Individual Income Tax Return
OM B No. 1545- 0074
, 2012, ending
For t h e year J an. 1- D ec. 31, 2012, or ot h er t ax year b eginning
IRS Use Only - D o not w rit e or st aple in t h is space.
See separate instructions.
Your social security number
, 20
555-55-1234
UNCW STUDENT
601 S COLLEGE RD APT. 230A
WILMINGTON, NC 28403-5901
Spouse's social security number
M ak e sure t h e SSN(s) ab ove
and on line 6c are correct .
Presidential Election Campaign
Foreign count ry name
Foreign province/ st at e/ count y Foreign post al cod e
Ch eck h ere if y ou, or y our spouse if f iling
j oint ly , w ant $3 t o go t o t h is f und . Ch eck ing
a b ox b elow w ill not ch ange y our t ax or
refund.
You
Filing Status
Check only
one box.
Exemptions
If more
than four
dependents,
see inst
and check
here
X Single
1
2
3
4
Married filing jointly (even if only one had income)
Married filing separately.Ent er spouse's SSN ab ove & f ull name h ere.
5
H ead of h ouseh old (w it h q ualif y ing person). (See inst ruct ions.)
If t h e q ualif y ing person is a ch ild b ut not y our d epend ent , ent er t h is
ch ild 's name h ere.
Qualifying widow(er) with dependent child
6a X Yourself. If someone can claim you as a dependent, do not check box 6a
Spouse
b
(2) D epend ent 's
c Dependents:
social securit y numb er
(1) First name
Last name
1
(3) D epend ent 's
relat ionsh ip t o y ou
B oxes ch eck ed
on 6a and 6b
No. of ch ild ren
on 6c who:
(4) if qual.
ch ild <17 f or lived w it h y ou
ch ild t ax cr.
d id not live w it h y ou
(see inst)
d ue t o d ivorce
or separat ion
(see inst)
D epend ent s
on 6c not
ent ered ab ove
Ad d numb ers
on lines
above
d Total number of exemptions claimed
7 Wages, salaries, tips, etc. Attach Form(s) W- 2
Income
Attach Form(s)
W-2 here. Also
attach Forms
W-2G and
1099-R if tax
was withheld.
If you did not
get a W-2,
see instructions.
Enclose, but do
not attach, any
payment. Also,
please use
Form 1040- V.
8a
b
9a
b
10
11
12
13
14
15a
16a
17
18
19
20a
21
Taxable interest. Attach Schedule B if required
8b
Tax- exempt interest. Do not include on line 8a
Ordinary dividends. Attach Schedule B if required
9b
Qualified dividends
Taxable refunds, credits, or offsets of state and local income taxes
Alimony received
Business income or (loss). Attach Schedule C or C-EZ
At t ach Sch ed ule D if req uired .
Capital gain or (loss).
If not req uired , ch eck h ere
Other gains or (losses). Attach Form 4797
15a
b Taxable amt
IRA distributions
16a
b Taxable amt
Pensions and annuities
Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E
Farm income or (loss). Attach Schedule F
Unemployment compensation
20a
b Taxable amount
Social security benefits
Other income. List type and amount
WORKSTUDY GRAND
22
23
24
10,000.
Combine the amounts in the far right column for lines 7 through 21. This is your total income
23
Educator expenses
Adjusted
Certain business expenses of reservists, performing artists, and
Gross
fee-basis government officials. Attach Form 2106 or 2106-EZ
24
Income
25 Health savings account deduction. Attach Form 8889
25
26 Moving expenses. Attach Form 3903
26
27 Deductible part of self-employment tax. Attach Schedule SE
27
28 Self-employed SEP, SIMPLE, and qualified plans
28
29 Self-employed health insurance deduction
29
30 Penalty on early withdrawal of savings
30
31a Alimony paid b Recipient's SSN
31a
32
32 IRA deduction
33 Student loan interest deduction
33
34 Tuition and fees. Attach Form 8917
34
35
35 Domestic production activities deduction. Attach Form 8903
36 Add lines 23 through 35
37 Subtract line 36 from line 22. This is your adjusted gross income
KBA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions.
1040 (2012)
Spouse
FD1040-1WV 1.25
Form Sof t w are Copyrigh t 1996 - 2013 H RB Tax Group, Inc.
1
7
8a
9a
10
11
12
13
14
15b
16b
17
18
19
20b
21
22
36
37
10,000.
10,000.
10,000.
Form 1040 (2012)
Form 1040 (2012)
UNCW STUDENT
38 Amount from line 37 (adjusted gross income)
You were born before January 2, 1948,
Blind.
Total boxes
39a Check
Spouse was born before January 2, 1948,
Blind.
if:
checked
39a
b If your spouse itemizes on a separate return or you were a dual- status alien, check here 39b
Tax and
Credits
Standard
Deduction
for People who
check any
box on line
39a or 39b
or who can
be claimed as
a dependent,
see instr.
40
Itemized deductions (from Schedule A) or your standard deduction (see left margin)
555-55-1234 Page 2
10,000.
38
40
5,950.
4,050.
Subtract line 40 from line 38
41
3,800.
Exemptions. Multiply $3,800 by the number on line 6d
42
250.
43
Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter - 026.
c
44
Tax Check if any from: a
Form(s) 8814 b
Form 4972
962 election
Alternative minimum tax (see instructions). Attach Form 6251
45
All others:
Single or
26.
46
Add lines 44 and 45
M arried f iling
separat ely,
Foreign tax credit. Attach Form 1116 if required
47
$5,950
Credit for child and dependent care expenses. Attach Form 2441
48
M arried f iling
j oint ly or
Education credits from Form 8863, line 19
49
Qualifying
Retirement savings contributions credit. Attach Form 8880
50
widow(er),
$11,900
Child tax credit. Attach Schedule 8812, if required
51
Head of
Residential energy credit. Attach Form 5695
h ouseh old ,
52
$8,700
Ot h er cred it s
c
53
3800
8801
b
a
from Form:
Add ln 47 through 53. These are your total credits
54
26.
55 Subtract line 54 from line 46. If line 54 is more than line 46, enter - 055
56
56 Self-employment tax. Attach Schedule SE
Other
b
57
8919
4137
57 Unreported social security and Medicare tax from Form: a
Taxes
58
58 Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required
59a
59a Household employment taxes from Schedule H
59b
b First- time homebuyer credit repayment. Attach Form 5405 if required
60
60 Other taxes. Enter code(s) from instructions
26.
61
61 Add lines 55 through 60. This is your total tax
Federal
income
tax
withheld
from
Forms
W-2
and
1099
62
62
Payments
63 2012 estimated tax payments and amount applied from 2011 return
63
If you have a
NO
Earned
income
credit
(EIC)
64a
64a
qualifying
64b
b Nontaxable combat pay election
child, attach
Schedule EIC. 65 Additional child tax credit. Attach Schedule 8812
65
66
66 American opportunity credit from Form 8863, line 8
67
67 Reserved
68
68 Amount paid with request for extension to file
69 Excess social security and tier 1 RRTA tax withheld
69
70 Credit for federal tax on fuels. Attach Form 4136
70
Re2439 b
71 Credits from Form:a
71
8801 d
8885
served c
0.
72
72 Add lines 62, 63, 64a, and 65 through 71. These are your total payments
73 If line 72 is more than line 61, subtract line 61 from line 72. This is the amount you overpaid
73
Refund
74a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here
74a
xxxxx
xxxx
XXXXXXXXX c Type:
Checking
Savings
b Routing number
Direct deposit?
XXXXXXXXXXXXXXXXXX
See
d Account number
instructions.
75 Amount of line 73 you want applied to your 2013 estimated tax
75
26.
Amount
76 Amount you owe. Subtract line 72 from line 61. For details on how to pay, see instructions
76
You Owe
77 Estimated tax penalty (see instructions)
77
X No
Do you want to allow another person to discuss this return with the IRS (see instructions)?
Yes. Complete below.
Third Party
Designee's name
Phone no.
Personal ID number
Designee
(PIN)
41
42
43
44
45
46
47
48
49
50
51
52
53
54
Und er penalt ies of perj ury, I d eclare t h at I h ave examined t h is ret urn and accompany ing sch ed ules and st at ement s, and t o t h e b est of my k now led ge and
b elief , t h ey are t rue, correct , and complet e. D eclarat ion of preparer (ot h er t h an t axpay er) is b ased on all inf ormat ion of w h ich preparer h as any k now led ge.
Sign
Here
Your signature
Joint return?
See instructions.
Keep a copy for
your records.
Paid
Preparer
Use Only
Your occupation
Date
Daytime phone number
STUDENT
Spouse's signature. If a joint return, both must sign.
Print/Type preparer's name
Preparer's signature
Firm's name
Firm's address
Date
Spouse's occupation
Date
Check
if
self-employed
If t h e IRS sent y ou an ID Prot ect ion
PIN, ent er it h ere (see inst .)
PTIN
Firm's EIN
Phone no.
Form 1040 (2012)
1040 (2012)
FD1040-2WV 1.25
Form Sof t w are Copyrigh t 1996 - 2013 H RB Tax Group, Inc.
2012 STATE TAX RETURN FILING INSTRUCTIONS
NORTH CAROLINA
FOR THE YEAR ENDING
December 31, 2012
Prepared for
Tax
Summary
UNCW STUDENT
Gross Income
Adjusted Gross Income
Total Deductions
Total Taxable Income
Total Tax
Total Payments
Refund Amount
Amount You Owe
Make check
payable to
NC Department of Revenue
Mailing
Address
North Carolina Dept. of Revenue
P.O. Box 25000
Raleigh, NC 27640-0640
Special
Instructions
SIGN AND DATE YOUR RETURN
Please sign and date Form NC D-400.
$
$
$
$
$
$
$
$
250
4,500
0
4,500
272
0
0
272
ASSEMBLE WHAT YOU NEED TO MAIL
Attach any schedules and forms behind Form NC D-400. If there
are supporting statements, arrange them in the same order as
the schedules and forms they support and attach them last.
Attach a copy of each W-2, W-2G, 1099R and 1099G for which NC
tax has been withheld.
PAY BALANCE DUE ON YOUR TAXES
Complete your check or money order for $272. Do not send
cash and do not forget to sign the check. Write your Social
Security number(s), daytime phone number, 2012, and Form
NC D-400on your check or money order (U.S. funds only).
MAIL FORM NC D-400 & NC D-400V & OTHER DOCUMENTS TO:
Mailing Address listed above.
To retain the proof of mailing, we recommend using certified
mail to send your form(s). When mailing to an address without
a P.O. box, you may also use:
Airborne Express, DHL Worldwide Express, FedEx, or UPS.
KEEP A COPY
Click on Main Menu and then E-File or Print to print your
return. Attach your copy of each W-2, W-2G, 1099R or 1099G
with withholding. Keep with your records for three years.
Check List (2012)
STCHECK-1WV 1.0
Form Sof t w are Copyrigh t 1996 - 2013 H RB Tax Group, Inc.
D-400 (48)
Individual Income Tax Return 2012
9-24-12
North Carolina Department of Revenue
< Staple All Pages of Your
Return and W-2s Here
12
For calendar year 2012, or fiscal year beginning
UNCW STUDENT
601 S COLLEGE RD
WILMINGTON NC 28403-5901 NEW H
Filing Status
X
Year spouse died:
230A
Select b ox if ret urn is f iled
and signed b y Execut or
or Ad minist rat or.
3. M arried Filing Separat ely
1
STUD
EX
01
601
PP
N
28403
UNCW
No
Yes
Yes
No
NC Political Parties Financing Fund
Your Spouse
You
01
Select appropriat e b ox if y ou w ant t o
d esignat e $3 t o t h is f und . Your t ax remains
t h e same w h et h er or not y ou mak e a
d esignat ion.
You
N
OC
N
NRT
N
PYT
N
PCT
DS
N
EA
N
NRS
N
PYS
N
PCS
Your Spouse
Democratic
Republican
Libertarian
Unspecified
Spouse
DT
STUDENT
X
555551234 You
Select b ox if you or your spouse w ere a nonresid ent of NC
f or t h e ent ire year.
Select b ox if you or your spouse moved int o or out of NC
d uring t h e year.
5. Wid ow (er) w it h D epend ent Ch ild
FS
Your SSN:
Spouse's SSN:
1. Single
4. H ead of H ouseh old
Select 'Yes' if y ou w ant t o d esignat e $3 of
t axes t o t h is special Fund f or vot er
ed ucat ion mat erials and f or cand id at es
w h o accept spend ing limit s. Select ing 'Yes'
d oes not ch ange y our t ax or ref und .
Number of Exemptions Claimed:
Return for deceased taxpayer
Date of death:
Return for deceased spouse
Date of death:
Select b ox if you or y our spouse
w ere out of t h e count ry on April
15 and a U.S. cit izen or resid ent .
2. M arried Filing J oint ly
NC Public Campaign Fund
and ending
N
PFT
0
PFS
0
Democratic
Republican
Libertarian
Unspecified
555551234
NC
230A
601 S COLLEGE RD
06
10000
23A
0
27D
07
0
23B
0
EU
09
0
24A
0
28
3000
24B
0
13
2500
24C
16
0.0000
17
28403
WILMINGTON
39
0
40
0
272
41
0
30
0
42
0
0
31
0
43
0
24D
0
33
0
44A
0
46
0
4500
25
0
34
0
44B
0
47
0
18
272
27A
272
35
0
44C
0
48
0
19
0
27B
0
36
0
44D
0
49
0
21
0
27C
0
38
0
45A
0
51
0
45B
0
52
0
11
TN
S
9109622502
Sign Return Below
PN
0
PP
0
Refund Due
I cert if y t h at , t o t h e b est of my know led ge, t h is ret urn is accurat e and complet e.
X
Payment Due
272
If prepared b y a person ot h er t h an t axpay er, t h is cert if icat ion is b ased on all
inf ormat ion of w h ich t h e preparer h as any k now led ge.
Your Signat ure
Date
Spouse's Signat ure (If f iling j oint ret urn, b ot h must sign.)
Date
Paid Preparer's Signat ure
Date
910 962 2502
H ome Teleph one Numb er (Includ e area cod e)
Paid Preparer's FEIN, SSN, or PTIN
Paid Preparer's Teleph one Numb er
If you ARE NOT due a refund, mail return, any payment, and Form D- 400V to: NCDOR, P.O. Box 25000, Raleigh, N.C. 27640- 0640
If REFUND mail to: NCDOR, P.O. Box R, Raleigh, N.C. 27634- 0001
D-400 2012 Page 2
(48)
Last Name (First 10 Characters)
STUDENT
Your Social Security Number
555551234
D-400 Line-by-Line Information
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
Federal adjusted gross income
Additions to federal adjusted gross income
Add Lines 6 and 7
Deductions from federal adjusted gross
income
Subtract Line 9 from Line 8
Deduction Type
N.C. standard deduction
N.C. itemized deduction
Subtract Line 11 from Line 10
N.C. personal exemption allowance
Subtract Line 13 from Line 12
Same as Line 14
Part-year residents and nonresidents
N.C. Taxable Income
N.C. Income Tax
Tax Credits
Subtract Line 19 from Line 18
Consumer Use Tax
Add Lines 20 and 21
North Carolina Income Tax Withheld
23a. Your Income Tax Withheld
23b. Spouse's Income Tax Withheld
24a.
24b.
24c.
24d.
25.
26.
27a.
27b.
27c.
EU
27d.
28.
29.
Other Tax Payments
2012 Estimated Tax
Paid with Extension
Partnership
S Corporation
North Carolina Earned Income Tax Credit
Add Lines 23a through 25
Tax Due - If Line 22 is more than Line 26,
subtract and enter the result
Penalties
Interest
Exception to underpayment of
estimated tax
Interest on the underpayment
of estimated income tax
Pay this Amount
Overpayment - If Line 22 is less than
Line 26, subtract and enter the result
6.
7.
8.
10000
0
10000
9.
10.
36.
37.
11.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
0
10000
S
3000
7000
2500
4500
4500
0.0000
4500
272
0
272
0
272
38.
39.
23a.
23b.
0
0
34.
35.
40.
41.
42.
43.
44.
44a.
44b.
44c.
44d.
44e.
45.
24a.
24b.
24c.
24d.
25.
26.
0
0
0
0
0
0
27a.
27b.
27c.
272
0
0
EU
45a.
44b.
45c.
46.
47.
48.
49.
27d.
28.
0
272
50.
29.
0
51.
Additions to Federal Adjusted Gross Income
Interest income from other states
34.
Adjustment for bonus depreciation
35.
(See instructions)
36.
Ot h er f ed eral ad j ust ed gross income ad d it ions
37.
Total additions
Deductions from Federal Adjusted
Gross Income
State or local income tax refund
38.
Interest income from obligations of
39.
US or US' possessions
Social Security and Railroad
Retirement Benefits
40.
41.
Bailey settlement retirement benefits
42.
Other retirement benefits
Severance wages
43.
Adjustment for bonus depreciation
added back in 2008, 2009, 2010 and 2011
2008
44a.
2009
44b.
2010
44c.
2011
44d.
Add Lines 44a, 44b, 44c and 44d and
enter on 44e
44e.
Adjustment for section 179 expense deduction
added back in 2010 and 2011
2010
45a.
2011
45b.
Add Lines 45a and 45b and enter on 45c
45c.
Contributions to North Carolina's National
College Savings Program (NC 529 Plan)
(See instructions)
46.
Adjustment for absorbed NOL
added back in 2003, 2004, 2005, and 2006 47.
Adjustment for net business income that
is not considered passive income
48.
Other federal adjusted gross income
deductions
49.
50.
Total deductions
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Part-Year Residents and Nonresidents
52.
53.
Amount of Refund to Apply to:
30. Amount of Line 29 to be applied to
2013 Estimated Income Tax
31. N.C. Nongame and Endangered
Wildlife Fund
32. Add Lines 30 and 31
30.
0
31.
32.
0
0
33. Amount to be Refunded
33.
0
This page must be filed with the first page of this form.
All income while a part-year NC resident and
NC source income while a nonresident
51.
Total income from all sources
52.
Divide Line 51 by Line 52
53.
N.C. Residency Dates for Part-Year Residents
Beginning
Ending
Taxpayer:
Spouse:
0
0
0.0000
D-400TC (48)
Individual Tax Credits 2012
9-25-12
North Carolina Department of Revenue
If you claim a tax credit on Line 19 or Line 25 of Form D- 400, you must attach this form to the return. If you do not, the tax credit may be disallowed.
Last Name (First 10 Characters)
STUDENT
Your Social Security Number
01
0
16
0
27B
0
02
0
20A
0
28A
04
0
20B
0
06
0
21
07A
0
07B
FM
N
GC
N
0
HD
N
PC
N
28B
0
CT
N
OS
N
0
29A
0
32
0
22
0
29B
0
36
0
0
23
0
30A
0
36
478
N
08
0
24
0
30B
0
38
QC
0
09
0
25
0
31
0
38
10
0
26
0
12
0
27A
0
14.
Credit for Income Tax Paid to Another State or Country N. C. Residents Only
1.
2.
3.
4.
5.
6.
7a.
7b.
Total income from 1040, Line 22; 1040A, Line 15;
1040EZ, Line 4, while a N.C. resident, adjusted by
applicable additions & deductions. Do not adjust
any portion of Lines 36 or 49 that does not relate
to gross income.
1.
Portion of Line 1 taxed outside N.C.
2.
Divide Line 2 by Line 1
3.
N.C. income tax (From D-400, Line 18)
4.
5.
Computed credit (Multiply Line 3 by Line 4)
Amount of net tax paid outside N.C. from
Line 2 (See instructions for definition of net
6.
tax paid)
7a.
Enter the lesser of Line 5 or Line 6
Number of states that credits are claimed
7b.
15.
0
0
0.0000
0
0
0
0
0
Credit for Child and Dependent Care Expenses
8.
9.
10.
11.
12.
13.
Enter the expenses from Line 3 of Federal Form
2441 (See instructions)
8.
Portion of Line 8 incurred for qualifying
9.
dependent(s)
Credit for Line 9 expenses (Use the Child
10.
and Dependent Care Credit Table)
Other qualifying expenses
11.
Credit for Line 11 expenses (Use the Child
and Dependent Care Credit Table)
12.
Total credit for child and dependent care
expenses. Full-year residents enter the
amount here and on Line 15 below
13.
This page must be filed with Form D- 400.
0
0
0
0
0
0
31
555551234
Part-year residents and nonresidents multiply
the amount on Line 13 by the decimal amount
from Form D- 400, Line 16. If Line 16 is more
than 1.0000, enter amount from Line 13 here
Total credit for child and dependent care
expenses from Line 13 or Line 14
0
14.
0
15.
0
Credit for Children under 17
on Last Day of Tax Year
Credit may be claimed only if amounts for your
filing status do not exceed:
- Married filing jointly/qualifying
widow(er) - $100,000
- Head of household - $80,000
- Single - $60,000
- Married filing separately - $50,000
16. Multiply the number of
children for whom you
are entitled to claim
the federal child tax
credit by $100 (Fullyear residents enter
this amount here and
on Line 18)
16.
17. Part-year residents and
nonresidents multiply
the amount on Line 16
by the decimal amount
17.
from Form D-400, Line
16 and enter the result
here and on Line 18
18. Credit for Children
18.
0
0
0
D-400TC 2012 Page 2 (48)
Last Name (First 10 Characters)
STUDENT
Your Social Security Number
D-400TC Line-by-Line Information
Other Tax Credits
19.
Add Lines 7a, 15, and 18
20a.
Total charitable contributions
Credit for charitable contributions
20b.
Credit for long-term care insurance premiums (See instructions)
21.
Credit for adoption expenses (See instructions)
22.
Credit for children with disabilities who require special education
23.
24.
Credit for Qualified Business Investments (You must attach a copy of the tax credit approval
letter that you received from the Department of Revenue.)
Credit for the disabled (Complete Form D- 429. Enter amount from Line 13 or 14)
25.
26.
Credit for certain real property land donations (See Instructions)
Enter expenditures and expenses on Lines 27a, 28a, 29a, and 30a only in the first year the credit is taken
Credit for rehabilitating an income-producing historic structure (See Instructions)
27.
27a.
Enter qualified rehabilitation expenditures
27b.
Enter installment amount of credit
28.
Credit for rehabilitating a nonincome-producing historic structure (See Instructions)
28a.
Enter rehabilitation expenses
28b.
Enter installment amount of credit
29.
Credit for rehabilitating an income-producing historic mill facility (See Instructions)
29a.
Enter qualified rehabilitation expenditures
29b.
Enter amount of credit
30.
Credit for rehabilitating a nonincome-producing historic mill facility (See Instructions)
Enter rehabilitation expenses
30a.
Enter installment amount of credit
30b.
31.
Other miscellaneous income tax credits
Property Taxes on Farm Machinery
Gleaned Crops
Handicapped Dwelling Units
Poultry Composting
Recycling Oyster Shells
Conservation Tillage Equipment
Tax credits carried over from previous year. Do not include NC- 478 carryovers.
32.
33.
Total (Add Lines 19, 20b, 21, 22, 23, 24, 25, 26, 27b, 28b, 29b, 30b, 31 and 32)
34.
Amount of tax (From D-400, Line 18)
35.
Enter the lesser of Line 33 or Line 34
36.
Business incentive and energy tax credits (Attach NC- 478 forms)
Is NC-478 attached?
37.
Add Lines 35 and 36
555551234
19.
20a.
20b.
21.
22.
23.
0
0
0
0
0
0
24.
25.
26.
0
0
0
27a.
27b.
0
0
28a.
28b.
0
0
29a.
29b.
0
0
30a.
30b.
31.
0
0
0
32.
33.
34.
35.
36.
0
0
0
0
0
N
0
37.
Earned Income Tax Credit
You are allowed a credit equal to 5% of the Earned Income Tax Credit allowed on your federal return. For part- year residents and
nonresidents, the credit must be prorated based on the ratio of income subject to North Carolina tax to total federal income.
38.
QC.
39.
40.
Enter the amount of your federal earned income tax credit.
Number of qualifying children
Multiply Line 38 by 5% (.05) Full- year residents enter this amount here and on Line 25 of form D- 400.
Part- year residents and nonresidents multiply the amount on Line 39 by the decimal amount from Form D- 400,
Line 12 and enter the result here and on Line 25 of Form D- 400. If Line 16 of Form D- 400 is more than 1.0000,
enter the amount from Line 39 here and on Line 25 of Form D- 400.
This page must be filed with the first page of this form.
38.
QC.
39.
40.
0
0
0
Department of the Treasury
Internal Revenue Service
Form 1040-V
Detach Coupon Below
Before Mailing
Make your check payable to the 'United States Treasury'.
Include in the check's memo section '2012 FORM 1040' and your SSN.
Mail payment voucher to:
INTERNAL REVENUE SERVICE
P. O. BOX 931000
LOUISVILLE, KY 40293-1000
KBA
Form 1040- V (2012)
Detach Here and Mail With Your Payment and Return
Department of the Treasury
Internal Revenue Service
2012
Use t h is vouch er w h en making a payment w it h Form 1040
D o not st aple t h is vouch er or your payment t o Form 1040
M ak e your ch eck or money ord er payab le t o t h e "Unit ed St at es Treasury "
Writ e your Social Securit y Numb er (SSN) on your ch eck or money ord er
Form 1040-V Payment Voucher
Amount you are paying
by check or money order
Dollars
26.
1029
UNCW STUDENT
601 S COLLEGE RD APT 230A
WILMINGTON NC 28403-5901
INTERNAL REVENUE SERVICE
P O BOX 931000
LOUISVILLE KY 40293-1000
555551234 CY STUD 30 0 201212 610
Instructions for Form D-400V, Payment Voucher
Enter "2012 Form D-400,"
your daytime phone number,
and your SSN on your check
or money order. If you are
filing a joint return, enter
the SSN shown first on your
return.
What Is Form D-400V and Why
Should You Use It?
It is a statement you send with
your payment of any balance due
on your 2012 Form D-400. Using
Form D-400V allows N.C. to process
your payment more accurately and
efficiently. We strongly encourage
you to use Form D-400V.
If you choose to file electronically
and have a balance due, follow
your transmitter's or preparer's
instructions for making your
payment.
Make your check or money
order payable in U.S. dollars to
the NC Department of Revenue.
Note: The Department will not
accept a check, money order,
or cashier's check unless it is
drawn on a U.S. (domestic)
bank and the funds are payable
in U.S. dollars.
Do not use the voucher to pay
quarterly estimated tax
Do not use a photocopy of the
voucher
Do not use another person's
voucher
Other Payment Methods
In lieu of using the payment
voucher below, you may pay
your tax online by bank draft, or
debit or credit card using Visa or
Mastercard. For details, go to our
website at www.dornc.com and
click on Electronic Services.
Make sure your name and
address appear on your check
or money order.
Do not staple, tape, paper clip
or otherwise attach your
check or money order to the
voucher
Do not fold the voucher or
check
What if You File
Electronically?
Preparing and Sending Your
Payment
Important Reminders
Do not send cash
Do not use this payment voucher if you pay your tax on-line.
Cut Here
D-400V (48)
Individual Income Payment Voucher
North Carolina Department of Revenue
9-16-08
555551234
STUD
UNCW
601
28403
STUDENT
601 S COLLEGE RD APT 230A
WILMINGTON
NC
For Calendar Year
2012
28403
$
Taxpayer/ Paid Preparer:
Date:
AMOUNT OF THIS PAYMENT
This must match the amount shown
on your check or money order.
Phone:
272.00
7270148006
Mail to:
20125 5555512343 0000000 06408
NCD OR, PO B ox 25000,
Raleigh , NC 27640- 0640