Form Ndw-R Reciprocity Exemption From Withholding For Qualifying Minnesota And Montana Residents Working In North Dakota Page 2

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Form NDW-R instructions
Instructions for
Instructions for
Fill out the form completely
employee
employer
If you do not fi ll in every item on this
form, your employer must withhold
North Dakota has income tax reciprocity
North Dakota income tax from your
Employees who reside in Minnesota or
agreements with Minnesota and Montana.
wages. Sign and date the form. Your
Montana who ask you not to withhold
If you are a resident of one of these
North Dakota income tax from their
phone number is not required, but we ask
states, the agreements provide that
for it so we can contact you if we have
wages must complete this form and give
you do not have to pay North Dakota
questions.
it to you by February 28 or within 30
income tax on wages you earn for work
days after they begin working for you
in North Dakota. If you are a resident
or change their residence. Employees
Your employer will be able to provide
of Minnesota, this applies only if you
you with the correct federal ID number if
who live in other states, including North
return to your permanent residence in
Dakota, cannot use this form.
you do not have this information.
Minnesota at least once a month.
Note: The wages you earn for work in
Make a copy of this form for your records
For forms received by February 28, mail
North Dakota are subject to income tax
and give the original to your employer.
the original on or before March 31 to:
in your state of residence.
Offi ce of State Tax Commissioner
600 E. Boulevard Ave., Dept. 127
Use of information
If you do not want North Dakota
Bismarck, ND 58505-0599
income tax withheld from your wages,
All information on this form is
you must complete this form and give
For new employees or employees who
confi dential by state law. It may only
it to your employer by February 28 of
change their permanent home address,
be given to your state of residence, the
the calendar year for which you want
mail the original to the above address
Internal Revenue Service, other states
it to apply, or within 30 days after you
within 30 days of receipt.
that guarantee the same confi dentiality,
begin working or change your permanent
and to other state agencies as provided by
residence. You must complete a new
Please verify your federal ID number is
law. The information may be compared
form and give it to your employer each
correct. Make a copy of the completed
with other information you furnished to
year to continue the exemption from
form for your records.
the Offi ce of State Tax Commissioner.
withholding.
If an employee does not fi ll in every item
Your name, address and social security
If you do not complete this form and give
on this form and the employee does not
number are required for identifi cation.
it to your employer as explained above,
correct the omission, you must withhold
Your address is also required to verify
your employer must withhold North
North Dakota income tax from the
your state of residence. Your employer’s
Dakota income tax from your wages.
employee’s wages.
name, address, federal ID number and
phone number are required in case we
If North Dakota income tax was
An employee must complete this form
have to contact your employer regarding
already withheld from your wages, you
and give it to you each year to continue
withholding income tax from your
must complete and fi le a North Dakota
the exemption from withholding.
wages. If you do not complete any of this
income tax return at the end of the year to
information, your employer is required to
obtain a refund.
withhold North Dakota income tax from
your wages.
Need forms or assistance?
Visit our Web site
You can download tax forms, ask us a question or send us a message via e-mail, and fi nd other useful information on our Web site
at:
Call us
For additional NDW-R forms, you may call (701) 328-1243.
For questions about this form or about income tax withholding, please call (701) 328-1248.
The speech or hearing impaired may call us through Relay North Dakota at 1-800-366-6888.
Write to us
You may also write to: Offi ce of State Tax Commissioner, 600 E. Boulevard Ave., Dept. 127, Bismarck, ND 58505-0599.

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