Form Nd-1 - Individual Income Tax Return - 2013
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1
2Form
North Dakota Office of State Tax Commissioner
2013
ND-1 Individual income tax return
WEB
If a fiscal year filer, enter
/
/
fiscal year end: (See page 11)
Please type or print in black or blue ink.
Your name (First, MI, Last name)
Your social security number
Date of death
Deceased
If joint return, spouse's name (First, MI, Last name)
Spouse's social security number
Deceased
Date of death
Mailing address
Apt No.
Fill in only if applicable: (See page 11)
Amended return: General
State
Amended return: Federal NOL
ZIP code
City
Extension
State
MN/MT Reciprocity
A. Filing status used
1. Single
4. Head of household
(See page 11)
on federal return:
2. Married filing jointly
5. Qualifying widow(er)
(Fill in only one)
with dependent child
3. Married filing separately
Attach a copy of your 2013
federal income tax return
C. Income source code:
B. School district code:
(See page 19)
(See page 11)
D. Federal adjusted gross income from line 37 of Form 1040, line 21 of Form 1040A,
or line 4 of Form 1040EZ
(SX) D
1. Federal taxable income from line 43 of Form 1040, line 27 of Form 1040A,
or line 6 of Form 1040EZ (If zero, see page 12 of instructions)
(SS) 1
Additions
2. Lump-sum distribution from Federal Form 4972
(NA) 2
3. Adjustment for loss from an S corporation that elected
(NB) 3
taxation under N.D.C.C. § 57-38-01.35
4. a. Planned gift or endowment tax credit adjustment to income
(NK) 4a
b. Housing incentive fund tax credit adjustment to income
(AP) 4b
5. Total additions. Add lines 2 through 4b
5
6. Add lines 1 and 5
6
Subtractions
7. Interest from U.S. obligations
(SN) 7
8. Net long-term capital gain exclusion
(NC) 8
(From worksheet on page 13 of instructions)
9. Exempt income of an eligible Native American
(S4) 9
10. Benefits received from U.S. Railroad Retirement Board
(S5) 10
11. Adjustment for income from an S corporation that elected
taxation under N.D.C.C. § 57-38-01.35
(S6) 11
12. National Guard/Reserve member federal active duty pay
(NI) 12
exclusion (Attach copy of Title 10 orders)
13. Nonresident only: Servicemembers Civil Relief Act adjustment
(Attach copy of Form W-2 showing this compensation)
(NJ) 13
14. College SAVE account deduction
(AA) 14
15. Qualified dividend exclusion
(AO) 15
16. Total other subtractions (Attach Schedule ND-1SA)
(AB) 16
17. Total subtractions. Add lines 7 through 16
17
18. North Dakota taxable income. Subtract line 17 from line 6. If less than zero, enter 0
(ND) 18
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