14b. b. Credit for Children (Complete the “Credit for Children Worksheet” in the instructions) If you claim a tax credit on Form D-400, Line 16, you must attach this form to the return. Otherwise, the tax credit may be disallowed. Part 1. Credit for Income Tax Paid to Another State or Country – N.C. Residents Only 5. Multiply Line 3 by Line 4 3. Divide Line 2 by Line 1 and enter the result as a decimal amount (Round to four decimal places) 1. Total income from all sources while a resident of N.C. modified by N.C. adjustments to federal gross income 2. Portion of Line 1 that was taxed by another state or country 4. Total North Carolina income tax (From Form D-400, Line 15) Amount of net tax paid to the other state or country on the income shown on Line 2 6. 7a. Credit for Income Tax Paid to Another State or Country Enter the lesser of Line 5 or Line 6 7b. Enter the number of states for which a credit is claimed 5. 3. 1. Enter Whole U.S. Dollars Only 2. 4. 6. 7a. 7b. Part 2. Credits for Rehabilitating Historic Structures Enter expenditures and expenses on Lines 8a, 9a, 10a, and 11a only in the first year the credit is taken. For Lines 8a and 9a the expenditures and expenses must have been incurred prior to January 1, 2015. Enter the installment amount of the tax credit on Lines 8b, 9b, and 11b, and the total amount of the tax credit on 10b. Total Tax Credits to be Taken for Tax Year 2017 (Add Lines 18 and 19. Enter the result here and on Form D-400, Line 16.) The amount on Line 20 cannot exceed the tax shown on Form D-400, Line 15. 20. 20. 18. Enter the lesser of Line 16 or Line 17 18. 17. North Carolina income tax (From Form D-400, Line 15) 17. 16. Add Lines 7a, 8b, 9b, 10b, 11b, 12, 13, 14b, and 15 16. 19. 19. Business incentive and energy tax credits (Attach Form NC-478 and any required supporting schedules to the front of Form D-400) 2017 Individual Income Tax Credits D-400TC 8b. 8. An income-producing historic structure (Article 3D) 8a. 11. 11b. A nonincome-producing historic mill facility (Article 3H) 11a. 9b. 9. A nonincome-producing historic structure (Article 3D) 9a. 10. 10b. An income-producing historic mill facility (Article 3H) 10a. 12. 12. An income-producing historic structure (Article 3L) (From Line 19 of Form NC-Rehab, Part 4) 15. 15. Tax credits carried over from previous years (Do not include any carryover of income tax credits taken on Form NC-478 or Form NC-Rehab.) 13. 13. A nonincome-producing historic structure (Article 3L) (From Line 22 of Form NC-Rehab, Part 4)

Part 3. Other Tax Credits and Computation of Total Tax Credits to be Taken for Tax Year 2017 If you take a credit on Lines 12 or 13, attach Form NC-Rehab to the front of Form D-400. Your Social Security Number Last Name (First 10 Characters) a. Number of dependent children for whom you were allowed a federal child tax credit 14. 14a. If you claim a tax credit for taxes paid to more than one state or country, do not complete Lines 1-6. Instead, complete the “Out-of-State Tax Credit Worksheet” in the instructions to determine the amount of Line 7a. Important: Refer to the Instructions before completing this form. Web-Fill 11-17 Do not send a photocopy of this form. DO NOT HAND WRITE ON THIS FORM DO NOT HAND WRITE ON THIS FORM 4 PRINT  CLEAR