One Time Remittance Form - North Dakota Office Of State Tax Commissioner 2007
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1North Dakota Office of State Tax Commissioner
One Time Remittance Form
Please check appropriate return - See page 2 for instructions
For Office Use Only
Voluntary Sales and Use Tax Return
Use Tax Return
Acct . # _______________________
Watercraft Use Tax Return (Invoice must be attached)
Do not use this form if you hold an active ND Sales and Use Tax Permit
Name
SSN or FEIN
Address
Phone
Zip Code
Date of Sale/Purchase
City, State
New mobile homes, new farm machinery and new farm irrigation equipment are taxed at 3 percent. All other
goods are taxed at 5 percent.
Column A
Column B
3% SALES & PURCHASES
5% SALES & PURCHASES
1. Total Sales (do not include tax)
2. Purchases Subject to Use Tax
3. Total Nontaxable Sales
4. Taxable Balance (Total of lines 1 and 2 minus
line 3)
5. State Tax (Multiply line 4 by the ND tax rate)
6. Total State Tax (Total of line 5 Column A and Column B
7. Local Option Sales & Use Tax
Total Local Option Tax
City or County Name
(Do Not Enter Sales)
Local Code
a.
b.
c.
d.
8. Net Local Option Tax Due (Total of lines 7a, 7b, 7c and 7d)
9. Total Due With Return (Add Lines 6 and 8)
Make check or money order payable to North Dakota Tax Commissioner
I declare that this return has been examined by me and to the best of my knowledge and belief is a true, correct, and complete return.
Taxpayer
Signature
Date
Title
Contact Person
Contact Phone
(Please print or type)
Number
For Watercraft Use Tax Only - please initial the Authorization box below
Authorization to Disclose Tax Information: The Tax Commissioner is hereby authorized to disclose confidential tax
information regarding the sale of this watercraft to the North Dakota Game and Fish Department to assist in the licensing of this
watercraft.
Signature of Tax
Date Use Tax Paid
Dept. Representative
Please Do Not
Please Mail To: Office of State Tax Commissioner
Write In This Space
Sales & Special Taxes Division
600 E. Boulevard Ave. Dept. 127
Bismarck, ND 58505-0599
21945
(Form revised 01/07)
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