Application for Extension for Filing Individual Income Tax Return
North Carolina Department of Revenue
Mail to: N.C. Department of Revenue
P.O. Box 25000, Raleigh, N.C. 27640-0635
You can le this form and pay the tax online at www.dornc.com.
Click on Electronic Services.
Use blue or black ink to complete this form.
Do not fold, staple, tape, or paper clip the form.
Detach and mail original form to:
N.C. Department of Revenue, P.O. Box 25000, Raleigh, NC 27640-0635
Enter Whole U.S. Dollars Only
For calendar year
Your Social Security Number Your Spouse’s Social Security Number
You must enter your
social security number(s)
Fill in this circle if you
were out of the country
on the date that this
application was due.
2. Payments for Year
1. Tax Liability for Year
(Line 1 minus Line 2)
or other tax
Your First Name
(USE CAPITAL LETTERS )
M.I. Your Last Name
If a Joint Return, Spouse’s First Name M.I. Spouse’s Last Name
Address Apartment Number
State Zip Code Country (If not U.S.)
Purpose - Use Form D-410 to ask for 6 more months to le the North
Carolina Individual Income Tax Return, Form D-400.
Even if you do not expect to owe additional tax, you must still apply
for an extension and le the return by the extended due date for the
return to be considered timely led. You do not have to explain why
you are asking for the extension. You do not have to attach this
form to your return.
To receive the extra time you MUST:
1. Properly estimate your tax liability using the information
available to you, and enter that amount on Line 1 of Form
2. File Form D-410 by the regular due date of your tax return.
You are not required to send a payment of the tax you
estimate as due. However, because an extension of time to
le the return does not extend the time for paying the tax, it
will benet you to pay as much as you can.
If you already had 4 extra months to le because you were “out of the
country” (explained later) when your return was due, then use this form
to ask for an additional 2 months to le.
Filing Your Tax Return - You may le the income tax return at any
time before the extended due date. But remember, Form D-410 does
not extend the time to pay the tax. If you do not pay the amount
due by the original due date, you will owe interest. You may also be
Interest - You will owe interest on tax not paid by the original due date
of the return. Even if you had a good reason not to pay on time, you
will still owe interest.
Late Payment Penalty - The late payment penalty is 10 percent of the
tax not paid by the due date of the return. The penalty will apply on any
remaining balance due if the tax paid by the original due date of the
return is less than 90 percent of the total amount of tax due. If the 90
percent rule is met, any remaining balance due, including interest,
Application for Extension
for Filing Individual Income Tax Return