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For Government stakeholders, we hope you find this resource page useful and informative. Our goal is to assist our stakeholders. For assistance with filling out forms or submitting online revenue reports, please contact our office at 701-328-2643 or email treasurer@nd.gov.

Important: These forms MUST be downloaded to function properly (may contain automatic calculations, field validations, tab order, etc.). Using the PDF viewer within the browser disables this functionality…

Download Instructions

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Accordion Section Title
Authorization for Direct Deposit Form - Political Subdivisions
Form Number Form Description Users Download Form Form Example 
SFN-14772 A form used to instruct the Office of State Treasurer to deposit tax distributions funds into specific bank accounts.  Can file multiple forms to have different tax distributions deposited into different accounts.  City, County and School District Officials  Download Form  Example 

 

Accordion Section Title
Authorization to Receive Checks from State Treasurer
Form Number Form Description Users  Download Form
SFN 7015  A form used to authorize specific individuals to be able to pick up agency checks from the Treasurer's Office.  State Agencies Download Form

 

Accordion Section Title
Void Check Request Form
Form Number Form Description Users Download Form Form Example

SFN-54494

A form used to notify the Office of State Treasurer a check needs to be voided.  This is NOT a stop payment.  State Agencies  Download Form  Example 

 

Accordion Section Title
County Township Road Mileage Certification Form
Form Number  Form Description Users Download Form Form Example
SFN-58292 A Certification of township road miles maintained within each county.  Updated biennial report is due July 1 of each even-numbered year.  County Officials  Download Form  Example 
Accordion Section Title
Senior Citizens Mill Levy/Match Annual Report
Form Number  Form Description Users  Download Form  Form Example
SFN-58180 A report filed annually by the counties to verify that grant funds received in the previous year were budgeted and used for permitted purposes.  Required annually by February 1.  County Auditors Download Form Example 
Accordion Section Title
Online Revenue Report System
Online System System Description Users  System Link  System Manua
Online Revenue Report System 

Online system for submitting monthly revenues collected per Century Code and remitted to the Office of State Treasurer to be appropriated to the applicable funds.

Reports Due Monthly by the 15th
 Refunds Due Monthly by the 24th

Clerks of Court & County Auditors & Treasurers  Link  Manual