Form ND-1 Fillable Individual Income Tax Form

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* Privacy Act See inside front cover of booklet contribution to: Wildlife Fund (SP) (AE) 25 (AJ) 30 (AN) 24 (Attach copy of Form W 2 showing this compensation) (NJ) 13 (Attach Schedule ND 1CR) (SD) 21 (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (Enter State) (Fill in only one) (From worksheet on page 13 of instructions) (NC) 8 (From worksheet on page 14 of instructions) (AC) 22 (SE) 27 (See page 11) (See page 15) (See page 19) (SQ) 32 (SR) 34 (SS) 1 (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) 5 1 Federal taxable income from line 43 of Form 1040 line 27 of Form 1040A 1 Single 18 North Dakota taxable income Subtract line 17 from line 6 If less than zero enter 0 (ND) 18 2 Married filing jointly 20 Tax If a full year resident enter amount from Tax Table on page 20 of instructions; however 2013 Form ND 1 page 2 25 Total other credits (Attach Schedule ND 1TC) 26 Total credits Add lines 21 through 25 27 Net tax liability Subtract line 26 from line 20 If less than zero enter 0 28 North Dakota withholding (Attach W 2s 1099s and/or N D K 1s) (SF) 28 3 Married filing separately 30 Total payments Add lines 28 and 29 32 Amount of line 31 that you want applied to your 2014 estimated tax 33 VoluntaryWatchable 34 Refund Subtract lines 32 and 33 from line 31 If less than $5 00 enter 0 35 Tax due If line 30 is LESS than line 27 subtract line 30 from line 27 36 Penalty (AK) Interest (AL) Enter total 36 37 Voluntary 38 Balance due Add lines 35 36 37 and if applicable line 39 39 Interest on underpaid estimated tax from Schedule ND 1UT (SO) 39 4 Head of household 5 Qualifying widow(er) A Filing status used a Planned gift or endowment tax credit adjustment to income (NK) 4a Add lines 1 and 5 6 Additions Adjustment for income from an S corporation that elected Adjustment for loss from an S corporation that elected Amended return: Federal NOL Amended return: General Apt No Attach a copy of your 2013 b Account number: B School district code: Benefits received from U S Railroad Retirement Board (S5) 10 Bismarck ND 58506 5621 C Income source code: c Type of account: Carryover of unused 2008 commercial property tax Carryover of unused 2008 residential/agricultural Checking College SAVE account deduction (AA) 14 complete items a b and c contribution to: credit Credit for income tax paid to another state Credits D Federal adjusted gross income from line 37 of Form 1040 line 21 of Form 1040A Date of death Date Phone number (land line) Deceased Deceased Date of death discuss this return with the paid preparer Enter Enter your North Dakota taxable income from line 18 of page 1 19 Estimated tax paid on 2013 Forms ND 1ES and ND 1EXT exclusion (Attach copy of Title 10 orders) (NI) 12 Exempt income of an eligible Native American(S4) 9 Extension federal income tax return Fill in only if applicable: (See page 11) fiscal year end: (See page 11) For a complete return you must attach a copy of your 2013 federal income tax return Form North Dakota Office of State Tax Commissioner Housing incentive fund tax credit adjustment to income (AP) 4b I authorize the ND Office of State Tax Commissioner to I declare that this return is correct and complete to the best of my knowledge and belief If a fiscal year filer enter If a full year nonresident or part year resident enter amount from Schedule ND 1NR If joint return spouse's name (First MI Last name) If less than $5 00 enter 0 (SZ) 35 if you have farm income or sold a research tax credit see page 13 of instructions; OR Interest from U S obligations (SN) 7 line 21; however if you sold a research tax credit see page 13 of instructions (SB) 20 Lump sum distribution from Federal Form 4972 (NA) 2 Mail to: State Tax Commissioner PO Box 5621 Mailing address Marriage penalty credit for joint filers MN/MT Reciprocity National Guard/Reserve member federal active duty pay ND 1 Individual income tax return Net long term capital gain exclusion Nonresident only: Servicemembers Civil Relief Act adjustment North Dakota Office of State Tax Commissioner on federal return: or line 4 of Form 1040EZ (SX) D or line 6 of Form 1040EZ (If zero see page 12 of instructions) otherwise go to line 35 If less than $5 00 enter 0 (SG) 31 Overpayment If line 30 is MORE than line 27 subtract line 27 from line 30; Paid preparer signature PTIN Date Pay to: ND State Tax Commissioner 38 Phone no Please type or print in black or blue ink plus an overpayment if any applied from your 2012 return (S&) 29 Print name of paid preparer Program Trust Fund (SW) Program Trust Fund (SY) property tax credit (AM) 23 Qualified dividend exclusion(AO) 15 Refund Savings Spouse's signature Date Cell phone number Spouse's social security number State State ZIP code Subtractions Tax calculation Tax Due Tax paid taxation under N D C C 57 38 01 35 (NB) 3 taxation under N D C C 57 38 01 35 (S6) 11 This Space Is For Tax Department Use Only To direct deposit your refund a Routing number: total 33 total 37 Total additions Add lines 2 through 4b5 Total other subtractions (Attach Schedule ND 1SA) (AB) 16 Total subtractions Add lines 7 through 16 17 Trees For ND Watchable Wildlife Fund (SU) with dependent child Your name (First MI Last name) Your signature Your social security number

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