North Dakota Individual Income Tax Form (EZ Version)

Individual Income Tax Form (EZ Version)
Form ND-EZ - Individual Income Tax Return (2023)
INDIVIDUAL INCOME TAX RETURN
OFFICE OF STATE TAX COMMISSIONER

Form ND-EZ

SFN 28745 (12-2023)

2023

For Full-Year Residents With No Adjustments Or Credits
Name (First, MI, Last Name)

Deceased

Date Of Death

Your Social Security Number

If Joint Return, Spouse's Name (First, MI, Last Name)

Deceased

Date Of Death

Spouse's Social Security Number

Apt. Number

Current Mailing Address
State

City

A. Filing status used on federal return: (Fill in only one)

B. School District Code:
(See instructions)

1. Single

4. Head of household

2. Married filing jointly

5. Qualifying surviving
spouse

3. Married filing separately

ZIP Code

For a complete return,
you must attach a copy of your
entire 2023 federal income tax return
D. Fill in if you obtained
an extension to file:
(See instructions)

C. Income Source Code:
(See instructions)

Extension

Tax Calculation
1. a. Federal adjusted gross income from Form 1040 or 1040-SR, line 11. If zero, enter 0

(SX) 1a
(ND) 1b

b. Federal taxable income from Form 1040 or 1040-SR, line 15. If zero, enter 0

(SB) 2

2. Tax - Enter tax on amount on Line 1b from Tax Table in instructions

Tax Paid
3. North Dakota income tax withheld from wages and other payments. (Attach Form W-2,
Form 1099, and/or North Dakota Schedule K-1)

(SF) 3

Refund
4. Overpayment - If line 3 is MORE than line 2, subtract line 2 from line 3; otherwise,
go to line 7. If less than $5.00, enter 0

(SG) 4

5. Voluntary contribution(s): Veterans' Postwar Trust Fund (AS)
Watchable Wildlife Fund (SP)

Enter
total

Trees For ND Trust Fund (SW)

6. Refund. Subtract line 5 from line 4. If less than $5.00, enter 0

5

(SR) 6

To direct deposit
a. Type Of Account
b. Routing Number
refund, complete items
Checking
Savings
a, b, and c. (See instructions)

c. Account Number

Tax Due
7. Tax due - If line 3 is LESS than line 2, subtract line 3 from line 2.
If less than $5.00, enter 0
8. Voluntary contribution(s): Veterans' Postwar Trust Fund
Watchable Wildlife Fund (SU)

(SZ) 7

(AT)

Enter
total

Trees For ND Trust Fund (SY)

8
9

9. Balance due. Add lines 7 and 8. Pay to: ND Office of State Tax Commissioner
Fill in the circles that apply:

1099-G consent-I agree to obtain Form 1099-G electronically at www.tax.nd.gov.

(See page 10 of 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 inside front cover of booklet.
Your Signature

Date

Telephone Number

Spouse's Signature

Date

Telephone Number

Paid Preparer Signature

Preparer Tax ID Number

Print Name Of Paid Preparer Signature

 Mail to: Office of State Tax Commissioner,
PO Box 5621, Bismarck, ND 58506-5621

This Space Is For Tax Department Use Only

Date

Telephone Number

IIT