Form ND-EZ Fillable Individual Income Tax Form
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

contribution to: Wildlife Fund (SP) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checking account) Unchecked (savings account) Unchecked (See page 19) (See page 9) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) 1 Single 2 Married filing jointly 2 Tax Enter tax on amount on line 1 from Tax Table on page 20 of instructions (SB) 2 3 Married filing separately 3 North Dakota withholding (Attach W 2s 1099s and/or North Dakota K 1s) (SF) 3 4 Head of household 5 Qualifying widow(er) 6 Refund a b and c (See page 9) b Account number: A Filing status used on federal return: (Fill in only one) a Routing number: Apt No B School district code: Balance due Add lines 7 and 8 Pay to: ND State Tax Commissioner 9 C Income source code: c Type of account Cell phone no Checking contribution to: Wildlife Fund (SU) D Federal adjusted gross income from line 37 of Form 1040 Date of death Deceased discuss this return with the paid preparer Enter extension of time to file Federal adjusted gross income Federal taxable income from line 43 of Form 1040 line 27 of Form 1040A Fill in if you obtained an For a complete return you must attach a copy of your 2013 federal tax return For a complete return you must complete Line D If zero enter 0 for full year residents with no adjustments or credits Form North Dakota Office of State Tax Commissioner 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 * Privacy Act See inside front cover of booklet If joint return spouse's name (First MI Last name) If less than $5 00 enter 0(SZ) 7 line 21 of Form 1040A or line 4 of Form 1040EZ(SX) D Mail to: Office of State Tax Commissioner Mailing address ND E Z Individual income tax return 2013 or line 6 of Form 1040EZ This is your North Dakota taxable income (ND) 1 otherwise go to line 7 If less than $5 00 enter 0 (SG) 4 Overpayment If line 3 is MORE than line 2 subtract line 2 from line 3; Paid preparer signature PTIN Date Phone no Phone number (land line) PO Box 5621 Bismarck ND 58506 5621 Print name of paid preparer Program Trust Fund (SW) Program Trust Fund (SY) Refund refund complete items Savings Spouse's signature Spouse's social security number* State Subtract line 5 from line 4 If less than $5 00 enter 0 (SR) 6 Tax calculation Tax due Tax due If line 3 is LESS than line 2 subtract line 3 from line 2 Tax paid This Space Is For Tax Department Use Only To direct deposit total Trees For ND Voluntary Watchable VoluntaryWatchable with dependent child Your name (First MI Last name) your return: (See page 9) Extension Your signature Your social security number* Zip code