INDIVIDUAL EXTENSION PAYMENT VOUCHER                                                      Form ND-1EXT
                    OFFICE OF STATE TAX COMMISSIONER
                    SFN 28713 (12-2022)
                                                                                                              2022

Purpose                                 How to make payment                                    Need help?
If you are applying for an extension    If paying by check or money                            Phone: 701-328-1247
of time to file your 2022 North         order, make the check or money                                   Speech or hearing impaired—
Dakota individual income tax return,    order payable to “ND State Tax                                   800-366-6888
you may make an extension payment       Commissioner,” and write last four 
to prepay the tax that you expect       digits of social security number(s)                    Email:  individualtax@nd.gov
to owe to avoid paying extension        and “2022 ND-1EXT” on check or 
interest.                               money order. Complete the payment                      Privacy Act Notification. In compliance 
                                        voucher below, detach it from this                     with the Privacy Act of 1974, disclosure of a 
                                                                                               social security number or Federal Employer 
If you make an extension payment,       page, and mail it with the check or                    Identification Number (FEIN) on this form is 
you must file Form ND-1 and claim       money order to:                                        required under N.D.C.C. §§ 57-01-15 and 
the payment on page 2, line 27.                                                                57-38-31, and will be used for tax reporting,
                                            Office of State Tax Commissioner                   identification, and administration of North
The payment must be made no                 PO Box 5622                                        Dakota tax laws. Disclosure is mandatory.
                                                                                               Failure to provide the social security number or
later than April 15, 2023, to avoid         Bismarck, ND 58506-5622                            FEIN may delay or prevent the processing of
extension interest.                                                                            this form.
                                        Only a check drawn on a U.S. or 
Important. Do not use this voucher      Canadian bank in U.S. dollars and 
if you:                                 using a standard 9-digit routing 
                                        number is accepted.                                     Record of payment
• Choose to make the payment
electronically—see “How to              Electronic payment option.                              Record the payment here and 
make payment” for your                  Instead of paying by check or money                     place in your 202 2tax records
payment options.                        order with this payment voucher, the 
• File your return on or before         payment may be made online with an                      Date of payment: ___________
April 15, 2023.                         electronic check or a debit or credit 
                                        card. If paying electronically, do                      Check number: _____________
• Pay your balance due after            not use this voucher.
April 15, 2023.                                                                                 Amount paid:  ______________
                                        To make an electronic payment, go to 
If you file your return after April 15, www.tax.nd.gov and select “Make 
2023, any tax paid with the return is   A Payment.”
subject to extension interest.

                                        ▼ Detach here and mail with payment ▼

FORM ND-1EXT  INDIVIDUAL EXTENSION PAYMENT VOUCHER                                                                       2022
North Dakota Office of State Tax Commissioner
SFN 28713 (12-2022)                                                                                      Due April 15, 2023
Do not use this voucher if paying electronically
Name                                                           Social Security
                                                               Number . . . . . . . . . . . . .►
Spouse's Name
                                                               Spouse's Social
                                                               Security Number . . . . . ►
Mailing Address

City, State, ZIP Code
                                                               Payment Amount  ► $
Mail payment and voucher to:  Office of State Tax Commissioner • Make payable to:
                                PO Box 5622                      ND State Tax Commissioner
                                Bismarck, ND 58506-5622        • Write last four digits of                               IIT
                                                               social security number and
                                                               "2022 ND-1EXT" on check