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Form 1040NMI
(Please type or print in ink) (See instructions on reverse side)
First name and middle initial
Present home address
Preparer’s
signature
Firm’s name
(or yours if self-employed),
address, and ZIP
Code
EIN
1 CNMI wages and salaries from Form(s) W-2CM . . . . . . . . . . . . . . . .
2 Other CNMI wages and salaries not included in line 1 . . . . . . . . . . . . . . .
3 Total CNMI wages and salaries (add lines 1 and 2) . . . . . . . . . . . . . . .
. . . . . . . . )DSW eludehcS hcatta( xat yralas dna egaw eht ot tcejbus ton 3 enil no tnuomA 4
. . . . . . . . . . . . . )3 enil morf 4 enil tcartbus( seiralas dna segaw IMNC elbaxaT 5
6 Tax. Annual wage and salary (see tax table on reverse side) . . . . . . . . . . . . .
Check if self
employed
Telephone no. ( )
Mailing address ZIP code
Last name
U.S. social security number
Citizenship
Form 1040NMI (2021)
EMPLOYEE’S ANNUAL WAGE AND SALARY
AND EARNINGS TAX RETURN
1 Wage and salary tax and earnings tax. Add line 6 Part A and line 7 Part B . . . . . . . . . 1
2 Education tax credit (attach Schedule ETC) . . . . . . . . . . . . . . . . . . 2
3 Tax after education tax credit. If line 2 is greater than line 1, enter zero. Otherwise subtract line 2 from line 1 3
4 Enter total wage and salary tax and earnings tax withheld and amount paid in 2021 . . . . . . . 4
Your signature Date Occupation
Date Preparer’s social security number
5 Net due or (overpaid). If negative, enclose amount in parenthesis ( ) . . . . . . . . .
5
PART A
Wage and
salary tax
computation
PART B
Earnings tax
computation
PART C
Combined
chapter 2
tax due or
(overpaid)
SIGN
HERE
1 Gain from the sale of personal property . . . . . . . . . . . . . . . . . .
1
2 One half of the gain from the sale of real property (see instructions) . . . . . . . . . . .
2
3 One half of the net income from leasing of real property . . . . . . . . . . . . . .
3
4a Gross winnings from any gaming, lottery, raffle, etc 4a
4b Less amount excludable . . . . . . . . 4b 4c Balance
4c
5 Other income subject to the earnings tax unless excludable under the earnings tax . . . . . . .
5
6 Taxable income subject to earnings tax (add lines 1 through 3, line 4c, and line 5 . . . . . . . 6
7 Annual earnings tax. (see tax table on reverse side) . . . . . . . . . . . . . . . 7
Paid
Preparer
Use
Only
Department of Finance
Division of Revenue and Taxation
Commonwealth of the Northern Mariana Islands
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, they are true, correct, and complete. Declaration of perparer (other than taxpayer) is based on all information of which preparer has any knowledge.
2021
INSTRUCTIONS FOR FORM 1040NMI (2021)
NOTE
Any person who has any income derived in the CNMI and is not required to file a NMTIT return (1040CM) in the CNMI must
file this return.
Type or print your first name, middle initial and last name in the space provided. Enter your citizenship, present home address (village), and your
complete mailing address, i.e. post office box number or general delivery, state, and zip code in the space provided. Type or print your U.S. Social
Security number. If you do not have a U.S. Social Security Number you must obtain one at the U.S. Social Security Administration office. If you are
not eligible to have a U.S. Social Security number, enter the taxpayer identification number (TIN) assigned to you on the space provided.
1. Enter the total wages and salaries received for work performed in the CNMI per Form(s) W-2CM, box 16. If two or more Form W-2CM were
received, combine the wages and salaries and enter the total.
2. Enter other wages and salaries received for work performed in the CNMI which Form(s) W-2CM were not issued or received, i.e. tips, bonuses,
freelance income, etc.
3. Add lines 1 and 2 and enter the total on this line.
4. Enter the amount not subject to the wage and salary tax. This includes amount in the CNMI government/agency employee’s W-2CM box 12,
i.e. housing benefits included in line 1, etc. Complete and attach Schedule WSD Wage and Salary Deduction for deductions taken on this line.
If Schedule WSD is not attached, the deduction will be disallowed.
5. Subtract line 4 from line 3. This is your CNMI wages and salaries that is subject to the wage and salary tax.
6. Compute your tax liability on income reported on line 5 by using the wage and salary and earnings tax table below.
1. Enter the amount of any gain from the sale of personal property (not business property).
2. Enter one-half (1/2) of the amount of any gain from the sale of real property located in the CNMI that was not used in the course of carrying on a
business. Exclude any gain from the sale of real property to the CNMI Government for public purpose.
3. Enter one-half (1/2) of the net income from leasing of real property located in the CNMI including the assignment of any lease that was not in the
course of carrying on a business.
4a. Enter the gross winnings from poker machine jackpot, any gaming, lottery, raffle or other gambling activities in the CNMI.
4b. Enter the amount of poker machine jackpot winnings if jackpot tax was withheld. Attach a copy of Form(s) W-2G.
4c. Subtract line 4b from line 4a.
5. Enter other income subject to the earnings tax unless it is excludable.
6. Add lines 1, 2, 3, 4c, and 5 of this part. This is the taxable earnings income subject to the earnings tax.
7.
Annual earnings tax. Compute the tax liability on income reported on line 6 by using the wage and salary and earnings tax table above.
1. Add the amount on line 6 of Part A and line 7 of Part B. This is your combined Chapter 2 tax due or (overpaid).
2. Enter the amount, if any, of cash contributions made during the tax year to a qualified educational institution or other tax-exempt educational
institution located in the CNMI. The maximum education tax credit (ETC) allowable is the lesser of cash contributions or the aggregate amount
of wage and salary tax, earnings tax, and business gross revenue tax liability. ETC may not exceed $5000.
3. Subtract line 2 from line 1. If line 2 is more than line 1, enter zero. This is the Chapter 2 tax after educational tax credit.
4. Enter the total wage and salary tax withheld and paid as shown in box 17 of the Form(s) W-2CM of 2021. Include any earnings tax (chapter 2)
withheld and/or paid in 2021.
5. Subtract line 4 from line 3. If negative, enclose figure in parenthesis ( ) to indicate an overpayment.
P
P
P (overpaid)
(a) 0 1,000.00 0
(b) 1,000.01 5,000.00 2.0%
(c) 5,000.01 7,000.00 3.0%
(d) 7,000.01 15,000.00 4.0%
(e) 15,000.01 22,000.00 5.0%
(f) 22,000.01 30,000.00 6.0%
(g) 30,000.01 40,000.00 7.0%
(h) 40,000.01 50,000.00 8.0%
(i) 50,000.01 and over 9.0%
TAX TABLE FOR WAGE AND SALARY AND EARNINGS TAX COMPUTATION
You must sign your name on the line provided before filing this return. If this return is prepared by a tax preparer, the preparer must also sign on the line provided
Rota District Office Tinian District Office
Division of Revenue and Taxation Division of Revenue and Taxation
P.O. Box 1406 P.O. Box 449
Saipan Central Office
Division of Revenue and Taxation
P.O. Box 5234 CHRB
Saipan MP 96950
Rota, MP 96951 Tinian, MP 96952
Deadline: April 18, 2022 Form
1040NMI (2021)
FROM
TO
RATE
If line 5 is an amount due and the return is filed and/or the tax is paid after the deadline, the amount due is subject to penalty and interest.
The penalty is 5% for failure to file and ½ of 1% for failure to pay for each month or fraction of a month after the due date, plus interest at prevailing
NMTIT rate(s). Please include these charges in your payment; otherwise, we will bill you for it.