Form Nd-1ext - Individual Extension Payment Voucher - 2012
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1North Dakota Offi ce of State Tax Commissioner
Form
ND-1EXT
Individual Extension Payment
2012
Purpose
To pay by check
Credit card payments must be made by
telephone or over the Internet through
Link2Gov Corporation, a private
If you are applying for an extension of
Complete the voucher below and mail
credit card payment service provider.
time to fi le your 2012 North Dakota
it with your check (or money order) to:
A fee will be charged to your credit
individual income tax return, you may
Offi ce of State Tax Commissioner
card by Link2Gov Corporation, which
make an extension payment to prepay
PO Box 5622
is retained by the provider for its
the tax that you expect to owe to avoid
Bismarck, ND 58506-5622
services—the State of North Dakota
paying extension interest.
does not receive any part of the fee.
When fi lling out the voucher:
If you make an extension payment,
To make your extension payment
you must fi le Form ND-1 and claim
• Make sure your social security
by credit card, go to Link2Gov
the payment on page 2, line 29; you
number is correct. We need it to
Corporation’s web site at
may not fi le Form ND-EZ.
properly credit your account.
or call them
• Enter your spouse’s social security
toll free at 1-888-ND-TAXES
You may pay by check or credit
number if you plan to fi le a joint
(1-888-638-2937).
card—see the separate instructions on
return.
this page for the payment procedures
Be sure to include the amount of your
under each method. Regardless of
Be sure to include the amount of your
payment on Form ND-1, line 29.
how you choose to make the payment,
payment on Form ND-1, line 29.
it must be made no later than April 15,
2013, to avoid extension interest.
To pay by credit card
Record of payment
Important. Do not use the voucher
Record the payment here and place in
I
f you choose to pay by credit card, do
below if you:
your 2012 tax records
not use the voucher below.
• Choose to make the extension
payment by credit card,
Date of payment: ______________
You may make your extension
• File your return on or before
payment using your MasterCard
®
,
Check number: ______________
April 15, 2013, or
®
®
American Express
Card, Discover
• Pay your balance due after April 15,
®
Card, or VISA
Card.
Amount paid: ______________
2013.
Any tax due with your return is subject
to extension interest.
Cut carefully along this line to detach.
ND-1EXT
Form ND-1EXT Individual extension payment voucher
North Dakota Office of State Tax Commissioner
2012
28713
Extension Payment (#5)
Due April 15, 2013
DO NOT use this voucher if paying by credit card
Name (first, middle initial and last)
Your Social Security Number
Spouse's Social Security Number
Spouse's Name (first, middle initial and last)
Mailing Address
Amount of Payment
City, State and Zip Code
For Tax
Department
use only
Make check or money order payable to "ND State Tax Commissioner."
•
Write social security number(s) and "2012 Form ND-1EXT" on check or
•
money order.
Mail to: Office of State Tax Commissioner, PO Box 5622, Bismarck, ND
IIT
•
58506-5622
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