NONRESIDENT PASSTHROUGH ENTITY MEMBER
                      WITHOLDING EXEMPTION AND CERTIFICATION
                      OFFICE OF STATE TAX COMMISSIONER
                      SFN 28754 (12-2022)                                                               Form PWE

Part 1 - Nonresident PTE member information
Nonresident PTE Member Name                                                          Federal Employer Identification Number*

Mailing Address

City                                                                                 State              ZIP Code

Contact Name                                                        Telephone Number Email Address

Entity type - Indicate how the entity is filing for federal income tax purposes by checking the appropriate box:
     Partnership      S corporation       Trust                     Grantor trust*   Disregarded entity*
*If "Grantor trust" or "Disregarded entity" is checked, identify Settlor or Owner in boxes below.
Name of Settlor/Owner                                                                Federal Employer Identification Number*

Part 2 - Passthrough entity information
Entity Name                                                                          Federal Employer Identification Number*

Mailing Address

City                                                                                 State          ZIP Code

Contact Name                                                        Telephone Number Email Address

Entity type - Indicate how the entity is filing for federal income tax purposes by checking the appropriate box:
     Partnership      S corporation       Trust                     Grantor trust*   Disregarded entity*
*If "Grantor trust" or "Disregarded entity" is checked, identify Settlor or Owner in boxes below.
Name of Settlor/Owner                                                                Federal Employer Identification Number*

Part 3 - Nonresident PTE member election and certification for exemption
Pursuant to N.D.C.C. § 57-38-31.1, the nonresident PTE member (in Part 1) elects exemption from income tax witholding on its
North Dakota distributive share of income from the passthrough entity (in Part 2), starting with the following tax year:
     Calendar year ______              Fiscal year beginning _______________, ______ and ending _____________, ______
This election remains in effect for all subsequent tax years until revoked.
Certification - The nonresident PTE member (in Part 1) certifies that it will file any return and pay any tax required under
N.D.C.C. ch. 57-38 and that it is subject to North Dakota's jurisdiction for the collection of the tax, and any applicable penalty and
interest, on its North Dakota distributive share of income from the passthrough entity (in Part 2).

Part 4 - Nonresident PTE member revocation of exemption
The nonresident PTE member (in Part 1) revokes the election and certification made on a Form PWE previously given to the
passthrough entity (in Part 2).  This revocation is effective beginning with the following tax year:
     Calendar year ______              Fiscal year beginning _______________, ______ and ending _____________, ______

Part 5 - Nonresident PTE member signature
I declare, under penalty of perjury, that this form is correct and complete to the best of my knowledge and belief.
Printed Name of Authorized Representative of Nonresident PTE Member                  Title

Signature of Authorized Representative                                               Date Signed

     *Privacy Act - See instructions

Form PWE
SFN 28754 (12-2022), Page 2

                                       An election remains in effect until     1. Check to see that all applicable 
Instructions to                        it is revoked by the nonresident         items on the form are filled in and 
                                       PTE member. The election does not        that the information in Part 2 is 
Form PWE                               affect the nonresident PTE member’s      correct.
                                       requirement to file a North Dakota      2. Do not withhold North Dakota 
Purpose of form                        income tax return and pay any tax        income tax on the nonresident 
Under North Dakota Century             due on its North Dakota distributive     PTE member’s North Dakota 
Code (N.D.C.C.) § 57-38-31.1, a        share of income.                         distributive share of income 
passthrough entity is required to                                               starting with the tax year 
withhold North Dakota income tax                                                specified in Part 3.
from a nonresident member’s North      Instructions for nonresident            3. On your North Dakota income 
Dakota distributive share of income.   PTE member                               tax return filed for each tax year 
A nonresident member that is a         Complete Form PWE as instructed          the election is in effect, fill in 
passthrough entity (nonresident        below and submit it to the               the circle under “Form PWA or 
PTE member) may elect to exempt        passthrough entity on or before the      Form PWE” for the nonresident 
its North Dakota distributive share    last day of the passthrough entity’s     PTE member on the applicable 
of income from this withholding        tax year. To make (or revoke) an         schedule as follows—
requirement. The election is made      election with respect to more than         If filing Form 38 (fiduciary 
on Form PWE.                           one passthrough entity, a separate        return), see Schedule BI, 
                                       Form PWE must be completed and            Column 6.
                                       given to each one. Keep a copy of 
General instructions                   the completed Form PWE for your            If filing Form 58 (partnership 
To elect exemption from North          records.                                  return), see Schedule KP, 
                                                                                 Column 7.
Dakota income tax withholding on 
its North Dakota distributive share    Making the election. To make the           If filing Form 60 (S corporation 
of income from a passthrough entity,   election, complete Parts 1, 2, 3,         return), see Schedule KS, 
a nonresident PTE member must          and 5. Do not complete Part 4. In         Column 7.
complete Form PWE and submit it to     Part 3, specify the tax year the        4. Attach a copy of the Form PWE 
the passthrough entity on or before    election is to take effect. If you       to your North Dakota income 
the last day of the passthrough        and the passthrough entity have          tax return for each tax year the 
entity’s tax year for which the        different tax years, specify the tax     election is in effect. Keep the 
election is to take effect.            year of the passthrough entity for       original signed Form PWE for your 
                                       which the election is to take effect.    records.
A “nonresident PTE member”             The election remains in effect until 
means a passthrough entity with a      you revoke it.                          Revocation. If you receive a 
commercial domicile outside North                                              Form PWE revoking a previously 
Dakota that owns an interest in, or    Revoking the election. To               made election, you must withhold 
is a beneficiary of, a passthrough     revoke a previously made election,      North Dakota income tax from the 
entity that is subject to the          complete Parts 1, 2, 4, and 5. Do       nonresident PTE member’s North 
withholding requirement under          not complete Part 3.                    Dakota distributive share of income 
N.D.C.C. § 57-38-31.1. Commercial                                              starting with the tax year specified 
domicile refers to the location of     Entity type. For purposes of the        in Part 4.
the principal office from which        entity type in Parts 1 and 2, the 
the entity’s activities are normally   following apply:
managed or directed.                     If the entity is a limited liability Need assistance?
                                        company, check the box                 Phone: 701.328.1247
A “passthrough entity” means            corresponding to how it is filing 
a general partnership, limited          for federal income tax purposes.       Speech or hearing impaired:
                                                                               1.800.366.6888 (Relay ND)
partnership, limited liability           If “Grantor trust” or “Disregarded 
partnership, limited liability          entity” is checked, provide the        Email: individualtax@nd.gov
limited partnership, S corporation,     name and social security number        Website: www.tax.nd.gov
trust, grantor trust, limited           (or FEIN) of the trust’s settlor or 
liability company not taxed as          entity’s owner.
a C  corporation, and any other                                                Privacy Act Notification. In compliance 
similar entity not taxed at the entity                                         with the Privacy Act of 1974, disclosure of a 
level for North Dakota income tax                                              social security number or Federal Employer 
purposes.                              Instructions for passthrough            Identification Number (FEIN) on this form is 
                                                                               required under N.D.C.C. §§ 57-01-15 and 
                                       entity                                  57-38-31.1, and will be used for tax reporting, 
                                       If you receive a Form PWE from a        identification, and administration of North 
                                                                               Dakota tax laws. Disclosure is mandatory. 
                                       nonresident PTE member, do the          Failure to provide the social security number or 
                                       following:                              FEIN may delay or prevent the processing of 
                                                                               this form.