Form SFN60576 "Declaration of Managers, Members, Governor's, Partners & Corporate Officers" - North Dakota

What Is Form SFN60576?

This is a legal form that was released by the North Dakota Office of State Tax Commissioner - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2014;
  • The latest edition provided by the North Dakota Office of State Tax Commissioner;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form SFN60576 by clicking the link below or browse more documents and templates provided by the North Dakota Office of State Tax Commissioner.

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Download Form SFN60576 "Declaration of Managers, Members, Governor's, Partners & Corporate Officers" - North Dakota

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DECLARATION OF MANAGERS, MEMBERS,
(001)
GOVERNOR'S, PARTNERS AND CORPORATE OFFICERS
NORTH DAKOTA OFFICE OF STATE TAX COMMISSIONER
SFN 60576 (Revised 2/14)
Pursuant to North Dakota Century Code §§ 57-39.2-18.1, 57-39.2-15.2, 57-39.2-15.3, 57-38-60.1,
57-38-60.2, and 57-38-60.3, the name(s), address(es), social security number(s) and signature(s) of the
corporate officer(s), manager(s), member(s), governor(s) and partner(s) responsible for the filing of the
sales and use tax or income tax withholding returns must be provided for the issuance of the sales and use
tax permit or an income tax withholding account. In addition, whenever this responsibility changes, this
office must be notified of the change. Failure to do so may result in issued permits or accounts being
revoked.
Federal Identification Number
Date
Legal Name
DBA Name
Title
Social Security Number
Printed Name
City
State
Address
ZIP Code
Title
Social Security Number
Printed Name
City
State
Address
ZIP Code
Title
Social Security Number
Printed Name
City
State
Address
ZIP Code
Title
Social Security Number
Printed Name
City
State
Address
ZIP Code
Title
Social Security Number
Printed Name
City
State
Address
ZIP Code
PRIVACY ACT NOTIFICATION
In compliance with the Privacy Act of 1974, disclosure of a social security number or Federal Employer Identification Number (FEIN) on
this form is required under N.D.C.C. §§ 57-01-15, 57-38-56, and 57-39.2-19, and will be used for tax reporting, identification, and
administration of North Dakota tax laws. Disclosure is mandatory. Failure to provide the social security number or FEIN may delay or
prevent the processing of this form.
DECLARATION OF MANAGERS, MEMBERS,
(001)
GOVERNOR'S, PARTNERS AND CORPORATE OFFICERS
NORTH DAKOTA OFFICE OF STATE TAX COMMISSIONER
SFN 60576 (Revised 2/14)
Pursuant to North Dakota Century Code §§ 57-39.2-18.1, 57-39.2-15.2, 57-39.2-15.3, 57-38-60.1,
57-38-60.2, and 57-38-60.3, the name(s), address(es), social security number(s) and signature(s) of the
corporate officer(s), manager(s), member(s), governor(s) and partner(s) responsible for the filing of the
sales and use tax or income tax withholding returns must be provided for the issuance of the sales and use
tax permit or an income tax withholding account. In addition, whenever this responsibility changes, this
office must be notified of the change. Failure to do so may result in issued permits or accounts being
revoked.
Federal Identification Number
Date
Legal Name
DBA Name
Title
Social Security Number
Printed Name
City
State
Address
ZIP Code
Title
Social Security Number
Printed Name
City
State
Address
ZIP Code
Title
Social Security Number
Printed Name
City
State
Address
ZIP Code
Title
Social Security Number
Printed Name
City
State
Address
ZIP Code
Title
Social Security Number
Printed Name
City
State
Address
ZIP Code
PRIVACY ACT NOTIFICATION
In compliance with the Privacy Act of 1974, disclosure of a social security number or Federal Employer Identification Number (FEIN) on
this form is required under N.D.C.C. §§ 57-01-15, 57-38-56, and 57-39.2-19, and will be used for tax reporting, identification, and
administration of North Dakota tax laws. Disclosure is mandatory. Failure to provide the social security number or FEIN may delay or
prevent the processing of this form.