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Form

North Dakota Office of State Tax Commissioner

Fiduciary income tax return

2012

Calendar year 2012

(Jan. 1 - Dec. 31, 2012)

A This return is

filed for:

Fiscal year:

Beginning

2012, and ending

B Name of estate or trust

C Federal

EIN *

Name and title of fiduciary

D Date

created:

Mailing address

Apt. or suite

E TOTAL no. of beneficiaries

Enter number of

State

Zip Code

City

Resident individual beneficiaries

Nonresident individual beneficiaries

Residency status:

Resident

Nonresident

Other types of beneficiaries

G Entity type:

Decedent's estate

Qualified disability trust

Bankruptcy estate (Ch. 7)

Other (Identify below):

Simple trust

ESBT (S portion only)

Bankruptcy estate (Ch. 11)

Complex trust

Pooled income fund

Grantor type trust

H Fill in all that apply:

Initial return

Final return

Composite return

Amended return

Extension

Before completing lines 1 through 17 on this page, complete the Tax Computation Schedule (on page 2).

1 Tax on fiduciary's North Dakota taxable income (page 2, Tax Computation Schedule, line 8)

2 Credit for income tax paid to another state (page 3, Schedule CR, line 7)

3 Other credits (Attach supporting schedule)

4 Net income tax liability on fiduciary's taxable income. Line 1 less lines 2 and 3

5 Income tax withheld from nonresident individual beneficiaries (page 3, Schedule BI, line 3)

6 Composite income tax for electing nonresident individual beneficiaries (page 3, Schedule BI, line 4)

7 Total taxes due. Add lines 4, 5, and 6

8 North Dakota income tax withholding (Attach supporting W-2s, W-2Gs, and 1099s)

9 Estimated tax paid on 2012 Forms 38-ES and 38-EXT

10 Total payments. Add lines 8 and 9

11 Overpayment. If line 10 is MORE than line 7, subtract line 7 from line 10 and enter result;

otherwise, go to line 14. If result is less than $5.00, enter 0

12 Amount of line 11 to be applied to 2013 estimated tax

13 Refund. Subtract line 12 from line 11. If result is less than $5.00, enter -0-

REFUND

14 Tax due. If line 10 is LESS than line 7, subtract line 10 from line 7.

If result is less than $5.00, enter 0

Interest

Enter total penalty and interest

15 Penalty

16 Balance due. Add lines 14, 15, and, if applicable, line 17

BALANCE DUE

17 Interest on underpaid estimated tax (from 2012 Schedule 38-UT)

Attach a complete copy of the 2012 Form 1041 (including Federal Schedule K-1s)

•

Attach a copy of all North Dakota Schedule K-1s (Form 38)

•

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

Date

Signature of fiduciary

I authorize the ND Office of State Tax Commissioner

to discuss this return with the paid preparer.

Print name of fiduciary

Phone

For Tax

Department

Use Only

Date

Paid preparer signature

Print name of paid preparer

PTIN

Phone

FID

Mail to: Office of State Tax Commissioner, 600 E. Blvd. Ave., Dept. 127,

Bismarck, ND 58505-0599

Form 38 - Fiduciary Income Tax Return - North Dakota Office Of State Tax Commissioner - 2012

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