North Dakota Exemption from Withholding for a Qualifying Spouse of a U.S. Armed Forces Servicemember

Exemption from Withholding for a Qualifying Spouse of a U.S. Armed Forces Servicemember
Form NDW-M - Exemption From Withholding For A Qualifying Spouse Of a U.S. Armed Forces Servicemember (2023)
FORM NDW-M - EXEMPTION FROM WITHHOLDING
FOR A QUALIFYING SPOUSE OF A U.S. ARMED
FORCES SERVICEMEMBER

For Calendar Year

OFFICE OF STATE TAX COMMISSIONER

20___

SFN 28720 (12-2023)

Employee - See "Instructions for employee" for eligibility requirements and other information.
Employer - See "Instructions for employer" for the purpose and proper handling of this form.

Part 1 - To be completed by the employee
Indicate YES or NO to the following statements by filling in the appropriate circle. If you answer NO to any of the statements,
you are not eligible for the withholding exemption.
Are you a civilian married to an active duty member of the U.S. armed forces?. . . . . . . . . . . . . .

YES

NO

Are you and your military spouse domiciled in a state other than North Dakota? . . . . . . . . . . . . .

YES

NO

Is your military spouse's permanent duty station in North Dakota? . . . . . . . . . . . . . . . . . . . . . .

YES

NO

Are you residing and working in North Dakota in order to be with your military spouse while
they are stationed in North Dakota? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

YES

NO

If all of the statements above are answered YES, provide the following for you (the employee) and your military spouse.
All boxes must be filled in to be valid.
Employee Name (First, MI, Last)

Social security number

State of domicile (legal residence)

Street address where currently residing

City

State

Social security number

Military Spouse Name (First, MI, Last)
Military spouse's permanent duty station

ZIP code

Military spouse's state of domicile (legal residence)

I declare, under penalty of perjury, that the wages I earn for my services performed in North Dakota are exempt from North
Dakota income tax because I meet the conditions for exemption under the Servicemembers Civil Relief Act (50 U.S.C. 4001),
and the information I provided on this form is accurate to the best of my knowledge and belief.
Employee's signature

Date signed

Telephone number

ATTACH A COPY OF YOUR DEPENDENT MILITARY ID CARD ISSUED BY THE U.S. DEPT. OF DEFENSE
Give the completed Form NDW-M with attached copy of military ID card to your employer.
Notify your employer if you become ineligible for this exemption - see instructions.
You must complete a new Form NDW-M each year to maintain the exemption - see instructions.

Part 2 - To be completed by the employer
Note: An employer shall be held harmless from liability for withholding based on the employee's
representations on this form.
Employer name
Address

Employer identification number (EIN)
City

State

ZIP code

See "Instructions for employer" for the proper handling of this form.
PRIVACY ACT NOTIFICATION
In compliance with the Privacy Act of 1974, 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 57-38-56, and will be used for tax reporting, identification, and administration of North Dakota tax laws.
Disclosure is mandatory. Failure to provide the social security number or FEIN may delay or prevent the processing of this form.

2022 Form NDW-M
SFN 28720 (12-2023)

Instructions to
Form NDW-M
Purpose of form
The Servicemembers Civil Relief Act
(50 U.S.C. 4001) provides that, if
certain conditions are met, wages that
a civilian spouse of an active duty
U.S. armed forces servicemember
receives for working in the state where
the servicemember is stationed are
exempt from that state’s income tax.
A qualifying civilian spouse must use
Form NDW-M to exempt the wages from
North Dakota income tax withholding.

		 Your domicile does not change if the
sole purpose of your movement from
one state to another is to reside
wherever your servicemember
spouse is permanently stationed.
		 You may elect to use the same state
of domicile as your servicemember
spouse for state tax purposes for
any tax year in which you are
married for any part of the year.
This means that, regardless of
where you are domiciled under
the normal rules (including North
Dakota), you will be treated as being
domiciled in the state where your
servicemember spouse is domiciled
for state tax purposes.

Completing Form NDW-M

You are eligible for the exemption from
North Dakota income tax withholding
on wages earned in North Dakota if you
meet all of the following conditions:

If you meet all of the eligibility
requirements for the exemption from
withholding, fill in the last two digits
of the calendar year in the upper
right-hand corner, then fill out Items 1
through 3 of Part 1. Attach a copy
of your dependent military ID card to
Form NDW-M, and give them to your
employer.

	 	 You are a civilian who is married to
an active duty U.S. armed forces
servicemember.

When the withholding
exemption takes effect

	 	 You and your servicemember spouse
maintain a domicile (that is, legal
residence) in a state other than
North Dakota. You do not have to
have the same state of domicile.
See “Domicile outside North Dakota”
below.

Form NDW-M takes effect on the
later of (1) the date you give it to
your employer or (2) the first payroll
period your employer is able to put the
exemption into effect. The exemption
does not apply to wages paid prior to
the date Form NDW-M takes effect.

	 	 Your servicemember spouse’s
permanent duty station is in North
Dakota.

Annual renewal

Instructions for employee
Eligibility

	 	The sole purpose for your presence
in North Dakota is to be with your
servicemember spouse.

Domicile outside North Dakota
“Domicile” refers to your residence
by law, and is also referred to as your
legal residence. It is the place that
is your permanent home, and is the
place to which you always intend to
return whenever you are absent from
it. Domicile is based on your intent and
actions, which must be consistent. If
you are a civilian spouse of an active
duty U.S. armed forces servicemember,
the Servicemembers Civil Relief Act
provides the following exceptions to
these domicile (or legal residence)
rules:

Form NDW-M is valid only for the
calendar year for which it is completed.
Provided you are still eligible, you
must file a new Form NDW-M for each
subsequent year you want to continue
the exemption from North Dakota
withholding.

Notification of ineligibility
You must notify your employer to begin
the withholding of North Dakota income
tax from your wages if you become
ineligible for the exemption. This would
occur in any of the following cases:
		 Divorce from the servicemember.
		 Death of the servicemember.
		 Change in domicile to North Dakota

by either spouse.

		 Change in the servicemember’s

permanent duty station to a location
outside North Dakota.

Instructions for employer
Requirement to withhold
North Dakota income tax law requires
you to withhold North Dakota income
tax from wages paid to an employee
if the employee performs services
within North Dakota and the wages
are subject to federal income tax
withholding.

Form NDW-M exemption
An exception to the requirement to
withhold North Dakota income tax
applies if an employee completes and
gives to you a Form NDW-M. This
exception applies only if you have a
Form NDW-M on file for the employee;
it is not enough that the employee is
eligible for the exemption under the
Act.

What you must do
If an employee gives you a completed
Form NDW-M, do the following:
	 1.	Check to see that all items in
Part 1 are filled in and a copy of
the employee’s dependent military
ID card is attached. If not, return
the form to the employee.
	 2.	Fill in Part 2.
	 3.	Keep the original signed
Form NDW-M and copy of the
military ID card for your records;
it relieves you of your obligation
to withhold North Dakota income
tax, and holds you harmless
from liability for the employee’s
representations on the form.
	 4.	Mail a copy of the completed
Form NDW-M and military ID card
to:
	
Withholding Tax Section
	
Office of State Tax Commissioner
	
600 E. Blvd. Ave., Dept. 127
	
Bismarck, ND 58505-0599
	
	

Alternatively, fax it to the
Withholding Tax Section at
701-328-0146, or email scanned
copies to [email protected].

For Assistance
If you have questions about this form,
call the Withholding Tax Section at
701-328-1248, or send an email to
[email protected].