1. Single

2. Married filing jointly

3. Married filing separately

4. Head of household

5. Qualifying widow(er)

 7.  Tax due -If line 3 is LESS than line 2, subtract line 3 from line 2.

        

 1.  Federal taxable income from line 43 of Form 1040, line 27 of Form 1040A,

      or line 6 of Form 1040EZ.

A.

from line 37 of Form 1040,

 3.

9.  Balance due.ND State Tax Commissioner

Mailing address

CityStateZip code

2013

If line 3 is MORE than line 2, subtract line 2 from line 3;

Deceased

(SX)  D

Your social security number*

Spouse's social security number*

(ND)  1

(SF)  3

(SZ)  7

9

Apt No.

 2.  Tax -(SB)  2

(SG)  4

5

5.

      contribution to:

Watchable

Wildlife Fund(SP)

Trees For ND

(SW)

Enter

total

6.  Refund.Subtract line 5 from line 4.

To 

8(SU)(SY)

Enter

total

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.

This Space Is For Tax Department Use Only

Phone number (land line)

Spouse's signature

Paid preparer signature                                                                    PTIN                                  Date

I authorize the ND Office of State Tax Commissioner todiscuss this return with the paid preparer.

Phone no.Print name of paid preparerit

Date

Type of account

Checking

Savings

c.

C.Income source code:

     

Tax calculation

Refund

Tax due

Form

ND-

North Dakota Office of State Tax Commissioner

Individual income tax return

for full-year residents with no adjustments or credits

Cell phone no.

Mail to: Office of State Tax Commissioner,

PO Box 5621, Bismarck, ND 58506-5621

B.School district code:

     

For a complete return, you must complete Line D.  If zero, enter 0.

Deceased

Extension

extension of time to file

Routing number:a.

b.Account number:

8.

     contribution to:

Watchable

Wildlife Fund

Trees For ND

IIT

Date of death

Date of death

MILast nameYour first name

MILast nameIf joint return, spouse's first name 

Fill in if you obtained an

your return: (See page 9)

Filing status used on federal return: (Fill in only one)

(See page 19)(See page 9)

with dependent child

Federal adjusted gross income    

 D.  Federal adjusted gross income

line 21 of Form 1040A, or line 4 of Form 1040EZ

This is your North Dakota taxable income

Enter tax on amount on line 1 from Tax Table on page 20 of instructions

North Dakota withholding(Attach W-2s, 1099s, and/or North Dakota K-1s)

Tax paid

 4.  Overpayment -

otherwise, go to line 7.If less than $5.00, enter 0

Voluntary

Program Trust Fund

If less than $5.00, enter 0

direct deposit

refund, complete items

If less than $5.00, enter 0

Program Trust Fund

Add lines 7 and 8.  Pay to:

For a complete return, you must attach a copy of your 2013 federal tax return

Your signatureDate

(SR) 6

Voluntary

EZ

a, b, and c. (See page 9)

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