2003 USE TAX RETURN
NORTH DAKOTA OFFICE OF STATE TAX COMMISSIONER
SFN 22076 (4-03)
(Please Print)
Name:
Area
Phone (
)
Address:
City:
State:
Zip:
State Use Tax
Column A
Column B
3%*
5%*
³
³
1. Purchases Subject To Use Tax (Enter under applicable rate) .............................
2. State Use Tax Due (Line 1 Col. A times .03 or Line 1 Col. B times .05) ...........
3. Total State Use Tax Due (Line 2 Col. A plus Line 2 Col. B) ...............................................................
*Please Note: New mobile homes, new farm machinery and new farm irrigation equipment are subject to 3 percent use
tax. To qualify for the reduced rate, the machinery, and irrigation equipment must be used exclusively for agricultural
purposes. All other goods are subject to 5 percent use tax.
Local Option Use Tax
Tangible personal property subject to North Dakota use tax also is subject to local use tax if the property is stored, used
or consumed within the borders of a location that imposes a local use tax. Please refer to the chart on the back of this return
for the tax rate for each location that has a local option use tax.
Local option use tax is limited to $25 per sale, except for Bottineau, Cavalier, Dickinson, Grand Forks, Hillsboro,
Jamestown, Medora, Minot, Oxbow and Williston. The maximum applies to the local option use tax only. North
Dakota state use tax applies to the full purchase price of the taxable goods. The maximum local option use tax calcula-
tions are listed in a table on the back of this return.
Please complete the local option tax section below for each of the locations in which you had taxable storage, use or
consumption of goods. See example below.
Net Taxable
Local Option
Location
Purchases
Tax Due
(Example)
Bismarck
250.00
2.50
³
a.
³
b.
Local Option
³
Use Tax
³
c.
³
d.
4. Total Local Use Tax Due (Total of Lines a through d) ........................................................................
5. Total State and Local Use Tax Due (Line 3 plus Line 4) ................................................................
Pay amount due on Line 5 to the ND Office Of State Tax Commissioner.
For assistance, write to the address below or call 701-328-3389.
Mail To:
Office Of State Tax Commissioner
Please Do Not Write In This Space
Sales And Special Taxes Division
600 E. Boulevard Ave., Dept. 127
Bismarck, ND 58505-0599
F22
000099603002003