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Schedule                         North Dakota Office of State Tax Commissioner

ND-1SA Statutory Adjustments
                                                                                                         2018
                                                                                                      Attach to Form ND-1
Your name  (First, MI, Last name)                                                         Your social security number

Important!  All taxpayers must read this section.  If you are claiming a deduction on line 1 or 2 of this schedule,
you must complete this section.  See "Property tax clearance" in instructions for details.

► Do you (or does your spouse, if filing jointly) hold a 50 percent or more ownership interest in real
   property located in North Dakota?                                                                                 Yes        No
   If yes, enter name of each North Dakota county in which you or your spouse holds a 50% or more interest in real property:
   _________________________________________________________________________________
Attach to Form ND-1 the completed Property Tax Clearance Record obtained from each county identified above.

1. Renaissance zone income exemption  (Attach Schedule RZ)                                (S7)  1
2. New or expanding business income exemption                                             (NH)  2
3. Human organ donor expense deduction                                                    (NL)  3
4. Employee workforce recruitment exclusion                                               (CA)  4
5. Total subtractions.  Add lines 1 through 4.  Enter result on Form ND-1, line 16         5

                                             section at the top of the schedule.  If      transplantation into another human being, 
Instructions                                 you are required to attach a property tax    you may deduct up to $10,000 of qualified 
If you have any of the adjustments shown     clearance record from a county, obtain one   expenses related to the donation that you 
on this schedule, you must complete and      by using the form Property Tax Clearance     incurred during the tax year.
attach it to Form ND-1.                      Record available on the Office of State Tax 
                                                                                          Qualified expenses means:
                                             Commissioner’s website.
                                                                                            Lost wages not compensated for by sick 
                                                                                           pay.
Disclosure notification
Upon written request from the chairman       Line 1 - Renaissance zone income               Unreimbursed medical expenses (as 
of a North Dakota legislative standing       exemption                                     defined for federal income tax purposes) 
committee or Legislative Management,         If you qualified for the business or          that you did not deduct in calculating 
the law requires the Office of State Tax     investment income exemption under the         your federal taxable income.  
                                             North Dakota renaissance zone program, 
Commissioner to disclose the amount of       enter the sum of the amounts from            The expenses are deductuble in the tax 
any deduction or credit claimed on a tax     Schedule RZ, Part 7, lines 1c and 1h.        year in which they are incurred.  They are 
return.  Any other confidential information, Attach Schedule RZ.                          incurred when the medical care is actually 
such as a taxpayer’s name or social security                                              provided, and not when the expenses are 
number, may not be disclosed.                                                             billed or paid.
                                             Line 2 - New or expanding 
                                             business income exemption                    Enter on this line qualified expenses 
Property tax clearance                       If you operate a business as a sole          incurred during the tax year.
North Dakota Century Code § 57-01-15.1       proprietorship and were granted a new or 
provides that, before certain state tax      expanding business income exemption          Line 4 - Employee workforce 
incentives may be claimed, a taxpayer        under N.D.C.C. ch. 40-57.1, enter the        recruitment exclusion
must obtain a property tax clearance record  portion of your net business income that     If you receive a statement from your 
from each North Dakota county in which       is eligible for the exemption.  For more     employer verifying that your employer 
the taxpayer holds a 50 percent or more      information on how to calculate the amount   qualified for the North Dakota workforce 
ownership interest in real property.  The    of the exempt income, see  North Dakota      recruitment income tax credit based on 
property tax clearance record(s) must be     Administrative Code § 81-03-01.1-06.         your employment, enter on this line the 
attached to the North Dakota tax return      Include on this line a new or expanding      amount of the signing bonus, moving 
on which the incentive is claimed.  The      business income exemption from a North       expense payment, or non-typical fringe 
deductions on lines 1 and 2 of this schedule Dakota Schedule K-1.                         benefit payment shown on the statement, 
are subject to this requirement.                                                          but only to the extent it is included in your 
                                             Line 3 - Organ donor deduction               federal taxable income for the tax year. 
If you are claiming the deduction on 
line 1 or line 2 of this schedule, you       If you or your dependent, while living,      Attach a copy of the statement received 
must complete the property tax clearance     donates part or all of a liver, pancreas,    from your employer.
                                             kidney, intestine, lung, or bone marrow for 






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