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SHORT FORM MEDICAL STATEMENT This form will be used for: 355 Maple Avenue Marysville, Pa 19438-2297 800.222.1981 www.harleysvillelife.com IMPORTANT: Submitting this form does not automatically entitle
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North Carolina short form is known as Form D-400.
Residents of North Carolina who have income from sources within the state are required to file Form D-400.
You can fill out Form D-400 by providing information about your income, deductions, and credits as instructed on the form.
The purpose of Form D-400 is to report and calculate an individual's state income tax liability in North Carolina.
On Form D-400, you must report your income, deductions, credits, and any tax payments made throughout the year.
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