Request for Assistance

You can use this web form to contact NCDOR if you did not receive a confirmation page after submitting a payment or filing, or if you encountered an error while using one of our File & Pay applications. For additional information, please read our FAQs.

First Name

Last Name

Business Name (if applicable)

This should be the legal name of the business.

Select Identification *

Last Four Digits of SSN or FID *

Payment Method

Last Four Digits of Bank Account or Credit/Debit Card Number

Draft Date

Month

Day

Year

Payment Amount

Application Used *

Select the application you were using when you received an error message.

Web Browser Used *

Browser Version *

The browser version is the numeric version of each program, such as Internet Explorer 8.0 and Firefox 3.5.

Error Message Received *

Provide any relevant information here, such as error messages received, or any other details about your issue.

Contact Person *

Email Address *

Contact Phone Number *

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Request for Assistance