INDIVIDUAL PAPER RETURN PAYMENT VOUCHER                                                Form ND-1PRV
               OFFICE OF STATE TAX COMMISSIONER
               SFN 28756 (12-2022)
                                                                                                      2022

What is Form ND-1PRV?                                                 Office of State Tax Commissioner
                                                                      PO Box 5621
The 2022 Form ND-1PRV is a payment voucher that you                   Bismarck, ND 58506-5621
complete and send in with your return if you:
  ● are filing your 2022 Form ND-EZ or Form ND-1 on                 Only a check drawn on a U.S. or Canadian bank in U.S. 
paper,                                                              dollars and using a standard 9-digit routing number is 
  ● have a balance due on your return, and                          accepted.

  ● are paying the balance due with a paper check or                Electronic payment option. Instead of paying by 
money order.                                                        check or money order with this payment voucher, the 
Do not use Form ND-1PRV if you filed or are going                   payment may be made online with an electronic check 
to file your return electronically, or are paying                   or a debit or credit card. To make an electronic payment, 
a balance due electronically - see “Electronic                      go to www.tax.nd.gov and select “Make A Payment.” If 
payment option.”                                                    paying electronically, do not use this voucher.
Also do not use this form to make an extension 
payment; instead, if you have an extension of time                  Need help?
to file your Form ND-1 and you want to make an                      Phone:  701-328-1242
advance payment of an expected balance due on it,                               Speech or hearing impaired - 800-366-6888
use Form ND-1EXT.                                                   Email:  individualtax@nd.gov

When is the payment due?
A balance due on a 2022 Form ND-EZ or 2022 
Form ND-1 must be paid on or before April 15, 2023, to              Privacy Act Notification. In compliance with the Privacy Act of 1974, 
avoid any late payment penalty and interest charges.                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 57-38-31, and will be used for tax reporting, identification, and 
How to make payment                                                 administration of North Dakota tax laws. Disclosure is mandatory. Failure 
                                                                    to provide the social security number or FEIN may delay or prevent the 
Make your check or money order payable to “ND State                 processing of this form.
Tax Commissioner.” Write the last four digits of your 
social security number and “2022 ND-1PRV” on your 
check or money order. Complete the payment voucher, 
detach it from this page, and mail it with your payment 
and return to:

                                  ▼ Detach here and mail with payment ▼

FORM ND-1PRV  INDIVIDUAL PAPER RETURN PAYMENT VOUCHER                                                 2022
North Dakota Office of State Tax Commissioner
SFN 28756 (12-2022)
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 5621               ND State Tax Commissioner
                                            Bismarck, ND 58506-5621 • Write last four digits of      ND-1PRV
                                                                     social security number and
                                                                     "2022 ND-1PRV" on check