For Tax
De
p
artment
use onl
y
Do Not use this voucher if paying electronically
Social Security Number
Name
City, State and ZIP Code
2013
Spouse's Name
Spouse's Social Security Number
Address
Preparer's Name
Preparer's Telephone Number
Amount of Payment
•
•
PO Box 5622
Bismarck, ND 58506-5622
ND-1V
Form ND-1V Electronic Return Payment Voucher
North Dakota Office of State Tax Commissioner
28726
•
Detach here and mail with your payment  
 
 
 
 
 
 
Address
Due 15th day of 4th month following end of tax year.
Make check or money order payable to "ND State Tax Commissioner."
Mail payment and voucher to:  Office of State Tax Commissioner
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