CORPORATION EXTENSION PAYMENT VOUCHER                                                           Form 40-EXT
                OFFICE OF STATE TAX COMMISSIONER
                SFN 28718 (12-2021)
                                                                                                                   2021

General information                    Regardless of which method of                          Office of State Tax Commissioner
                                       payment is chosen, it must be made                     600 E. Boulevard Ave., Dept. 127
The purpose of Form 40-EXT,            no later than the original due date of                 Bismarck, ND 58505-0599
Corporation Extension Payment          the return.
Voucher, is to provide a corporation                                                          The payment must be accompanied 
that is unable to file its Form 40,    A corporation filing on a fiscal year                  by a completed Form 40-EXT.
Corporation Income Tax Return, by      basis or on a short period return 
the due date, the means of remitting   must enter the tax year beginning                      To pay electronically
its tax payment on or before the       and ending dates on the Form 40-EXT 
original due date of the return.       voucher, otherwise leave blank.                        If you choose to pay electronically, 
                                                                                              do not use the voucher below.
A corporation must prepay its entire   To pay by check
state tax liability by the regular due                                                        An extension payment may be made 
date of the tax return for the taxable Complete the voucher below and mail                    electronically using an ACH credit, 
year, or interest at the rate of 12%   it with your check (or money order)                    electronic check, debit card, or credit 
per annum will apply to any payment    to:                                                    card. To make an electronic payment 
made after the regular due date of                                                            or for information regarding an 
the state tax return.                                                                         ACH credit, go to the department’s 
                                                                                              website at www.nd.gov/tax.
The extension payment may be 
made by check, money order, or 
electronically.                                                                      Do Not Use This Voucher If:

                                                •  The extension payment is made using any type of electronic payment

                                                •  The return is filed on or before the original due date of the return

                                                •  The balance due is going to be paid after the original due date of the 
                                                return

                                                •  The corporation files Form 60, Small Business Corporation Income 
                                                Tax Return

                                                PRIVACY ACT NOTIFICATION
In compliance with the Privacy Act of 1974, disclosure of a social security number or Federal Employer Identification Number (FEIN) on this 
form is required under N.D.C.C. §§ 57-01-15 and 57-38-32, and will be used for tax reporting, identification, and administration of North 
Dakota tax laws. Disclosure is mandatory. Failure to provide the social security number or FEIN may delay or prevent the processing of this 
form.

                                       ▼ Detach here and mail with payment ▼

FORM 40-EXT  CORPORATION EXTENSION PAYMENT VOUCHER                                                                 2021
North Dakota Office of State Tax Commissioner
     SFN 28718 (12-2021)
Do not use this voucher if paying electronically
Name Of Corporation As It Will Appear On Form 40
                                                                            Federal Employer
                                                                            Identification Number . . . ►
Mailing Address
                                                                            Tax Year Beginning
                                                                            (mm/dd/yyyy) . . . . . . . . ►
City, State, ZIP Code
                                                                            Tax Year Ending
                                                                            (mm/dd/yyyy) . . . . . . . . ►

                                                                            Payment Amount  ► $

     • Due 15th day of 4th month following end of tax year                           • Make payable to:
     • Mail payment and voucher to:  Office of State Tax Commissioner                  ND State Tax Commissioner
                                                    600 E. Boulevard Ave., Dept. 127                                 CIT
                                                                                       Write "2021 40-EXT" on check
                                                    Bismarck, ND 58505-0599          •