Fillable Form ND-1: INDIVIDUAL INCOME TAX RETURN (State of North Dakota)

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Form ND-1: INDIVIDUAL INCOME TAX RETURN (State of North Dakota)

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File type: PDF

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(AB) 16
(S5) 9
1. Single
2. Married filing jointly
3. Married filing separately
4. Head of household
5. Qualifying widow(er)
6. Interest from U.S. obligations
b. Federal taxable income from Form 1040 or 1040-SR, line 15.
If z
ero, see instructions
A.
Filing status used
o
n federal return:
(
Fill in onl
y
one
)
B. School district code:
(See instructions)
C. I
ncome source code:
(
See instructions
)
1. a. Federal adjusted gross income from Form 1040 or 1040-SR, line 11.
If zero, enter zero
2.
Lump-sum distribution from Federal Form 4972
3.
Loss from S corporation taxed as C corporation
7. Ne
t lon
g
-term ca
p
ital
g
ain exclusion
(
From worksheet in instructions
)
8. Exempt income of an eligible Native American
9. Benefits received from U.S. Railroad Retirement Board
10.
I
ncome from S cor
p
oration taxed as C cor
p
oration
16.
T
otal other subtractions
(
Attach Schedule ND-1SA
)
18. North Dakota taxable income. Subtract line 17 from line 5b.
If l
ess than zero, enter 0
Additions
Subtractions
Name (First, MI, Last Name)
If Joint Return, Spouse's Name (First, MI, Last Name)
Current Mailing Address
City
State
ZIP Code
with de
p
endent child
11.
N
onresident onl
y
: Servicemembers Civil Relief Act ad
j
ustment
Attach co
of Form W-2 showin
this com
ensation
12. North Dakota Colle
g
e SAVE account deduction
17. Total subtractions. Add lines 6 throu
g
h 16
4. Planned gift or endowment tax credit adjustment to income
Deceased
Amended: General
Amended: Federal NOL
(SX) 1a
Your Social Security Number
Spouse's Social Security Number
/
/
F. MN/MT Reci
p
rocit
y
(
See instructions
)
(SS) 1b
(NA) 2
(NB) 3
(NK) 4
(SN) 6
(S4) 8
(S6) 10
(NJ) 11
(AA) 12
(ND)18
Apt Number
17
5. a. Total additions. Add lines 2 through 4
5a
(AO) 13
13.
Q
ualified dividend exclusion
If a fiscal
y
ear filer, enter
fiscal
y
ear end:
(
See instructions
)
(NC) 7
Date Of Death
Attach a copy of your entire 2021 federal
income tax return
Attach W-2s, 1099s, and ND Sch. K-1s
showing ND income tax withholding
State
Deceased
14. Militar
y
retirement
p
a
y
exclusion
(AQ) 14
(AR) 15
15. Social securit
y
benefit exclusion
(
See instructions
)
Date Of Death
b. Add lines 1b and 5a
5b
D. Fill in if a
pp
licable:
(
See instructions
)
INDIVIDUAL INCOME TAX RETURN
OFFICE OF STATE TAX COMMISSIONER
SFN 28702
(
12-2021
)
Form ND-1
2021
Extension
E. Fill in if a
pp
licable:
(
See instr.
)
(AE) 23
(SQ) 30
(AK) (AL)
2021 Form ND-1
SFN 28702
(
12-2021
)
, Pa
g
e 2
21. Credit for income tax
p
aid to another state or local
j
urisdiction
in that state
(
Attach Schedule ND-1CR
)
22. Marriage penalty credit for joint filers (See worksheet in instr.)
24.
To
tal credits. Add lines 20 throu
g
h 23
25. Net tax liabilit
y
. Subtract line 24 from line 19. If less than zero, enter 0
26. North Dakota income tax withheld from wa
g
es and other
p
a
y
ments
(
Attach Forms W-2 and 1099, and ND Sch. K-1
)
27. Estimated tax paid on 2021 Forms ND-1ES and ND-1EXT
pl
us an overpayment, if any, applied from your 2020 return
28.
T
otal
p
a
y
ments. Add lines 26 and 27
29.
Ov
er
p
a
y
ment - If line 28 is MORE than line 25, subtract line 25 from line 28;
ot
herwise,
g
o to line 33. If less than $5.00, enter 0
30. Amount of line 29 that
y
ou want a
pp
lied to
y
our 2022 estimated tax
32. Refund. Subtract lines 30 and 31 from line 29. If less than $5.00, enter 0
33. Tax due - If line 28 is LESS than line 25, subtract line 28 from line 25.
If less than $5.00
,
enter 0
36. Balance due. Add lines 33, 34, 35, and, if a
pp
licable, line 37.
Pa
y
to: ND State Tax Commissioner
37.
In
terest on under
p
aid estimated tax from Schedule ND-1UT
To direct de
p
osit
y
our refund,
com
p
lete items a, b, and c.
(
See instructions
)
Refund
Tax Due
Tax
p
aid
Other credits
34. Penalt
y
Interest
Enter total
(SD) 21
(AC) 22
34
(SZ) 33
(SO) 37
36
(SR) 32
31. Voluntar
y
contribution
(
s
)
: Veterans' Postwar Trust Fund
Enter
total
31
(SG) 29
(AJ) 28
(S&) 27
(SF) 26
(SE) 25
24
23. Total other credits
(
Attach Schedule ND-1TC
)
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.
Mail to: Office of State Tax Commissioner,
PO Box 5621, Bismarck, ND 58506-5621
(AS)
35. Voluntar
y
contribution
(
s
)
: Veterans' Postwar Trust Fund
Enter
total
35
(AT)
c. Account Numberb. Routing Number
Checking Savings
a. Type Of Account
(SB) 19
19. Tax - If full-year resident, enter tax on amount on line 18 from Tax Table in instructions.
I
f full-year nonresident or part-year resident, enter tax from Schedule ND-1NR, line 23.
All filers: If you have farm income or sold a research credit, see instructions
(AU) 20
Watchable Wildlife Fund
(SP)
Trees For ND Trust Fund
(SY)
Watchable Wildlife Fund
(SU)
1099-G consent-I a
g
ree to obtain Form 1099-G electronicall
y
at www.nd.
g
ov/tax.
Disclosure authorization-I authorize the ND Office of State Tax Commissioner to
discuss this return with the
p
aid
p
re
p
arer identified below.
Fill in the circles that a
pp
l
y
:
(See page 16 of instructions)
IIT
This Space Is For Tax Department Use Only
Your Signature
Date
Telephone Number
Spouse's Signature
Paid Pre
p
arer Si
g
nature
PTIN
Date
Telephone Number
Print Name Of Paid Preparer Signature
Date
Telephone Number
Trees For ND Trust Fund
(SW)
20. TAX RELIEF CREDIT - Full-year residents only. If single,
head of household, qualifying widow(er), or married filing
separately, enter $350. If married filin
g
j
ointly, enter $700.
(See instructions)
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Form ND-1: INDIVIDUAL INCOME TAX RETURN (State of North Dakota)

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Completed 11 February 2022

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