1 1 2 2 1 2 3 3 5 6 7 8 910 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 3 84 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 67 69 71 73 75 77 79 81 83 85 4 INDIVIDUAL INCOME TAX RETURN 5 NORTH DAKOTA OFFICE OF STATE TAX COMMISSIONER 5 6 6 SFN 28702 (12-2022) FORM ND-1 7 7 8 8 9 2022 9 10 If a fiscal year filer, enter 10 SSN-99-9999 SSN-99-9999 MM/DD/ YYYY 11 Deceased: Date of death: fiscal year end: 11 12 Amended: General 12 PRIMARY(FIRST M LAST) X MM/DD/ YYYY D. Fill in if applicable: X 13 SPOUSE (FIRST M LAST) X (see instructions) Amended: Federal NOL X 13 14 MM/DD/ YYYY 14 E. Fill in if applicable: Extension X 15 (see instructions) 15 MAILINGADDRESS UNIT# (append unit# to address) 16 MAILINGADDRESSLINE2 F. MN/MT Reciprocity: X State XX 16 17 (see instructions) 17 CITY STATE ZIP 18 18 COUNTRY (IF <> USA) 19 19 20 A. Filing status X 1. Single X 4. Head of household 20 21 used on 2. Married filing jointly 5. Qualifying widow(er) with 21 X X 22 federal return:X 3. Married filing separately dependent child 22 23 23 24 B. School district code: 99-999 Reserved for 24 25 (see instructions) 25 2D Barcode 26 C. Income source code: 26 99 27 (see instructions) 27 28 28 29 Attach a copy of your entire 2022 federal income tax return. 29 30 30 31 1.a. Federal adjusted gross income from Form 1040 or Form 1040-SR, line 11. If zero, enter 0. (SX) 1a 99999999999999 31 32 32 b. Federal taxable income from Form 1040 or Form 1040-SR, line 15. If zero, see instructions. 33 (SS) 1b 99999999999999 33 34 34 35 Additions 35 36 36 37 2. Lump-sum distribution from Federal Form 4972 (NA) 2 99999999999999 37 38 3. Loss from S corporation taxed as a C corporation (NB) 3 99999999999999 38 39 4. Planned gift or endowment tax credit adjustment to income (NK) 4 99999999999999 39 40 5.a. Total additions. Add lines 2 through 4 5a 99999999999999 40 41 b. Add lines 1b and 5a 5b 99999999999999 41 42 42 43 Subtractions 43 44 44 45 6. Interest from U.S. obligations (SN) 6 99999999999999 45 46 7. Net long-term capital gain exclusion (From worksheet in instructions) (NC) 7 99999999999999 46 47 8. Exempt income of an eligible Native American (S4) 8 99999999999999 47 48 9. Benefits received from U.S. Railroad Retirement Board (S5) 9 99999999999999 48 49 10. Income from S corporation taxed as a C corporation (S6) 10 99999999999999 49 50 11. Nonresident only: Servicemembers Civil Relief Act adjustment (Attach copy of Form W-2) (NJ) 11 99999999999999 50 51 12. North Dakota College SAVE account deduction (AA) 12 99999999999999 51 52 13. Qualified dividend exclusion (AO) 13 99999999999999 52 53 14. Military retirement pay exclusion (Attach 1099-R) (AQ) 14 99999999999999 53 54 15. Social Security benefit exclusion (See instructions) (AR) 15 99999999999999 54 55 55 56 56 57 16. Total other subtractions (Attach Schedule ND-1SA) (AB) 16 99999999999999 57 58 58 17. Total subtractions. Add lines 6 through 16 59 17 99999999999999 59 60 60 61 (ND) 18 99999999999999 61 18. North Dakota taxable income. Subtract line 17 from line 5b. If less than zero, enter 0 62 62 NACTP 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 67 69 71 73 75 77 79 81 83 85 1 2 3 645 6 7 8 910 12 14 16 18 20 22 24 26 28 30 32 34 36 www.tax.nd.gov38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 64 84 65 65 66 66 |
1 1 2 2 1 2 3 3 5 6 7 8 910 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 3 84 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 67 69 71 73 75 77 79 81 83 85 4 SSN-XX-XXXX SSN-XX-XXXX 5 2022 FORM ND-1 5 6 SFN 28702 (12-2022), Page 2 6 7 7 8 8 9 9 19. Tax. If a full-year resident, enter tax on amount on line 18 from Tax Table in instructions. 10 If a full-year nonresident or part-year resident, enter tax from Schedule ND-1NR, line 23; (SB) 19 99999999999999 10 11 All filers: If you have farm income or sold a research credit, see instructions. 11 12 12 20. TAX RELIEF CREDIT - Full-year residents only. If single, head of household, qualifying 13 widow(er), or married filing separately, enter $350. If married filing jointly, enter $700. (AU) 20 99999999999999 13 14 14 15 Other Credits 15 16 21. Credit for income tax paid to another state or local jurisdiction (Attach Schedule ND-1CR) (SD) 21 99999999999999 16 17 22. Marriage penalty credit for joint filers (See worksheet in instructions) (AC) 22 99999999999999 17 18 23. Total other credits (Attach Schedule ND-1TC) (AE) 23 99999999999999 18 19 24. Total credits. Add lines 20 through 23 24 99999999999999 19 20 25. Net tax liability. Subtract line 24 from line 19. If less than zero, enter 0 (SE) 25 99999999999999 20 21 21 22 Tax Paid 22 23 23 26. North Dakota income tax withheld from wages and other payments 24 (Attach W-2s, 1099s, and/or N.D. K-1s) (SF) 26 99999999999999 24 25 25 27. Estimated tax paid on 2022 Forms ND-1ES and ND-1EXT 26 plus an overpayment, if any, applied from your 2021 return (S&) 27 99999999999999 26 27 28. Total payments. Add lines 26 and 27 (AJ) 28 99999999999999 27 28 28 29 Refund 29 30 30 29. Overpayment - If line 28 is MORE than line 25, subtract line 25 from line 28; 31 otherwise, go to line 33. If less than $5.00, enter 0 (SG) 29 99999999999999 31 32 30. Amount of line 29 that you want applied to your 2023 estimated tax (SQ) 30 99999999999999 32 33 31. Voluntary contribution to: Watchable Wildlife Fund (SP) 9999999 33 34 Trees for ND Program Trust Fund (SW) 9999999 34 35 Veterans' Postwar Trust Fund (AS) 9999999 Enter total: 31 99999999999999 35 36 36 37 32. Refund. Subtract lines 30 and 31 from line 29. If less than $5.00, enter 0 (SR) 32 99999999999999 37 To direct deposit your refund, complete 38 a. Type of account: XXChecking Savings 38 39 items a, b, and c. (See instructions) b. Routing Number: 999999999 39 40 c. Account Number: 99999999999999999 40 41 Tax Due 41 42 33. Tax due - If line 28 is LESS than line 25, subtract line 28 from line 25. If less than $5.00, enter 0 (SZ) 33 99999999999999 42 43 34. Penalty (AK) 99999999999 Interest (AL) 99999999999 Enter total:34 99999999999999 43 44 35. Voluntary contribution to: Watchable Wildlife Fund (SU) 9999999 44 45 Trees for ND Program Trust Fund (SY) 9999999 45 46 Veterans' Postwar Trust Fund (AT) 9999999 Enter total:35 99999999999999 46 47 36 99999999999999 47 36. Balance due. Add lines 33,34, 35, and if applicable, line 37. Pay to: ND State Tax Commissioner 48 37. Interest on underpaid estimated tax from Schedule ND-1UT (SO) 37 99999999999999 48 49 49 50 1099-G consent - I agree to obtain Form 1099-G electronically at www.tax.nd.gov. 50 51 Check the boxes that apply: X 51 (see instructions) X Disclosure Authorization - I authorize the ND Office of State Tax Commissioner to discuss this return 52 with the paid preparer identified below. 52 53 I declare that this return is correct and complete to the best of my knowledge and belief. *Privacy Act - See instructions 53 54 Your Signature Date Telephone Number This Space Is For Tax Department Use Only 54 55 (999) 999-9999 55 56 Spouse's Signature Date Telephone Number 56 57 (999) 999-9999 57 58 Paid Preparer Signature PTIN Date 58 59 59 60 Print Name of Paid Preparer Signature Telephone Number 60 61 (999) 999-9999 61 62 Attach copy of 2022 Mail to: State Tax Commissioner, PO Box 5621, 62 federal income tax return Bismarck, ND 58506-5621 IIT 1 2 3 645 6 7 8 910 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 74 76 78 80 6484 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 67 69 71 73 75 77 79 81 83 85 65 65 66 66 |
INDIVIDUAL INCOME TAX RETURN NORTH DAKOTA OFFICE OF STATE TAX COMMISSIONER SFN 28702 (12-2022) FORM ND-1 2022 If a fiscal year filer, enter / / Deceased: Date of death: fiscal year end: / / D. Fill in if applicable: Amended: General / / (see instructions) Amended: Federal NOL E. Fill in if applicable: Extension (see instructions) F. MN/MT Reciprocity: State (see instructions) A. Filing status 1. Single 4. Head of household used on 2. Married filing jointly 5. Qualifying widow(er) with federal return: 3. Married filing separately dependent child B. School district code: - (see instructions) C. Income source code: (see instructions) Attach a copy of your entire 2022 federal income tax return. 1.a. Federal adjusted gross income from Form 1040 or Form 1040-SR, line 11. If zero, enter 0. (SX) 1a b. Federal taxable income from Form 1040 or Form 1040-SR, line 15. If zero, see instructions. (SS) 1b Additions 2. Lump-sum distribution from Federal Form 4972 (NA) 2 3. Loss from S corporation taxed as a C corporation (NB) 3 4. Planned gift or endowment tax credit adjustment to income (NK) 4 5.a. Total additions. Add lines 2 through 4 5a b. Add lines 1b and 5a 5b Subtractions 6. Interest from U.S. obligations (SN) 6 7. Net long-term capital gain exclusion (From worksheet in instructions) (NC) 7 8. Exempt income of an eligible Native American (S4) 8 9. Benefits received from U.S. Railroad Retirement Board (S5) 9 10. Income from S corporation taxed as a C corporation (S6) 10 11. Nonresident only: Servicemembers Civil Relief Act adjustment (Attach copy of Form W-2) (NJ) 11 12. North Dakota College SAVE account deduction (AA) 12 13. Qualified dividend exclusion (AO) 13 14. Military retirement pay exclusion (Attach 1099-R) (AQ) 14 15. Social Security benefit exclusion (See instructions) (AR) 15 16. Total other subtractions (Attach Schedule ND-1SA) (AB) 16 17. Total subtractions. Add lines 6 through 16 17 18. North Dakota taxable income. Subtract line 17 from line 5b. If less than zero, enter 0 (ND) 18 www.tax.nd.gov |
2022 FORM ND-1 SFN 28702 (12-2022), Page 2 19. Tax. If a full-year resident, enter tax on amount on line 18 from Tax Table in instructions. If a full-year nonresident or part-year resident, enter tax from Schedule ND-1NR, line 23; (SB) 19 All filers: If you have farm income or sold a research credit, see instructions. 20. TAX RELIEF CREDIT - Full-year residents only. If single, head of household, qualifying widow(er), or married filing separately, enter $350. If married filing jointly, enter $700. (AU) 20 Other Credits 21. Credit for income tax paid to another state or local jurisdiction (Attach Schedule ND-1CR) (SD) 21 22. Marriage penalty credit for joint filers (See worksheet in instructions) (AC) 22 23. Total other credits (Attach Schedule ND-1TC) (AE) 23 24. Total credits. Add lines 20 through 23 24 25. Net tax liability. Subtract line 24 from line 19. If less than zero, enter 0 (SE) 25 Tax Paid 26. North Dakota income tax withheld from wages and other payments (Attach W-2s, 1099s, and/or N.D. K-1s) (SF) 26 27. Estimated tax paid on 2022 Forms ND-1ES and ND-1EXT plus an overpayment, if any, applied from your 2021 return (S&) 27 28. Total payments. Add lines 26 and 27 (AJ) 28 Refund 29. Overpayment - If line 28 is MORE than line 25, subtract line 25 from line 28; otherwise, go to line 33. If less than $5.00, enter 0 (SG) 29 30. Amount of line 29 that you want applied to your 2023 estimated tax (SQ) 30 31. Voluntary contribution to: Watchable Wildlife Fund (SP) Trees for ND Program Trust Fund (SW) Veterans' Postwar Trust Fund (AS) Enter total: 31 32. Refund. Subtract lines 30 and 31 from line 29. If less than $5.00, enter 0 (SR) 32 To direct deposit your refund, complete a. Type of account: Checking Savings items a, b, and c. (See instructions) b. Routing Number: c. Account Number: Tax Due 33. Tax due - If line 28 is LESS than line 25, subtract line 28 from line 25. If less than $5.00, enter 0 (SZ) 33 34. Penalty (AK) Interest (AL) Enter total:34 35. Voluntary contribution to: Watchable Wildlife Fund (SU) Trees for ND Program Trust Fund (SY) Veterans' Postwar Trust Fund (AT) Enter total:35 36. Balance due. Add lines 33,34, 35, and if applicable, line 37. Pay to: ND State Tax Commissioner 36 37. Interest on underpaid estimated tax from Schedule ND-1UT (SO) 37 1099-G consent - I agree to obtain Form 1099-G electronically at www.tax.nd.gov. Check the boxes that apply: (see instructions) Disclosure Authorization - I authorize the ND Office of State Tax Commissioner to discuss this return with the paid preparer identified below. I declare that this return is correct and complete to the best of my knowledge and belief. *Privacy Act - See instructions Your Signature Date Telephone Number This Space Is For Tax Department Use Only Spouse's Signature Date Telephone Number Paid Preparer Signature PTIN Date Print Name of Paid Preparer Signature Telephone Number Attach copy of 2022 Mail to: State Tax Commissioner, PO Box 5621, federal income tax return Bismarck, ND 58506-5621 IIT |