DIVISION OF REVENUE AND TAXATION

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Lizbeth Gilmore
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1 DVO VU D XO CO O W C O WL D 00Z-C orm OL DVDUL CO X U O GL D JO L WH O DD D C OUC CO OLY C L L L CO O H H H D L D L O H H H O O CL U OLY 0 lease type or print in ink n n Home address number and street f you have a O bo pt no oreign country name ake sure the s above are correct oreign province/state/county oreign postal code ncome Wages, salaries, and tips his should be shown in box of your W-C formss ttach your W-C forms orms W-C here nclose, but axable interest f the total is over $,00, you cannot use orm 00Z Unemployment compensation and laska ermanent und dividends ee page for explanation dd lines,, and his is your adjusted gross income f someone can claim you or your spouse if a joint return as a dependent, check the applicable boxes below and enter the amount from the worksheet on page You any payment pouse f no one can claim you or your spouse if a joint return enter $0,00 if single; $0,00 if jointly ubtract line from line f line is larger than line, enter -0- his is your taxable income ayments, Credits, and ax Chapter income tax withheld from box of your forms W-C and 0 8a arned income credit 8a 8b b dd lines and 8a hese are your total payments and credits 0 ax Use the amount on line above hen, enter the tax from the table on this line 0 dd lines 0 and his is your total tax efund f line is larger than line, subtract line from line his is your refund before rebate mount you owe f line is larger than line, subtract line from line his is the amount you owe before rebate hird arty Designee ign Here Joint return? Yes Complete below hone no Designee s name of which the preparer has any knowledge Your signature number Keep a copy for your records pouse s signature f a joint return, both rint/ype preparer s name aid reparer Use Only o reparer s signature Check if self-employed irm s name irm s irm s address hone no orm 00Z-C 0 age

2 orm 00Z-C 0 Use this form if illing in your return or tips on how to avoid common mistakes, see nstructions Your filing status is single or married filing jointly f you are not sure about your filing status, see instructions You and you spouse if married filing jointly were under and not blind at the end of 0 f you were born on January,, you are considered to be age at the end of 0 You do not claim any dependents or information on dependents, see ublication 0 Your taxable income line is less than $00,000 You do not claim any adjustments to income or information on adjustments to income, use the ax opics listed under djustments to ncome at wwwirsgov/taxtopics see instructions he only tax credit you can claim is the earned income credit C he credit may give you a refund even if you do not owe any tax You do not need a qualifying child to claim the C or information on credits, use the ax opics listed under ax Credits at wwwirsgov/taxtopics see instructions f you received a orm 08- or paid higher education expenses, you may be eligible for a tax credit or deduction that you must claim on orm 00-C or orm 00C or more information on tax benefits for education, see ub 0 You had only C source wages, salaries, tips, taxable scholarship or fellowship grants, D your total taxable interest was not over: - $,000 if filing single O - $,00 if filing jointly, and neither you nor your spouse individually has interest income in excess of $,000 f you earned tips, including allocated tips, that were not included in box and box of your W-C, you may not be able to use orm 00Z-C see instructions f you are planning to use orm 00Z-C for a child who received laska ermanent und dividends, see the exception below xception to using orm 00Z-C f you have unemployment compensation or laska ermanent und dividends, you may not be able to use this form, as such income is generally not C source Unless the total djusted Gross ncome on line is not more than the exemption amount on line and you have no further income tax withheld, you must use orm 00-C or orm 00-C f you received a scholarship or fellowship grant or tax-exempt interest income, such as on municipal bonds, see the instructions before filling in the form lso, see the instructions if you received a orm 0- showing federal income tax or withheld or if federal income tax was withheld from your unemployment compensation or laska ermanent und dividends emember, you must report all wages, salaries, and tips even if you do not get a orm W-C from your employer You must also report all your taxable interest, including interest from banks, savings and loans, credit unions, etc, even if you did not get a orm 0- Use this worksheet to figure the amount to enter on line if someone can claim you or your spouse if married filing jointly as a dependent, even if that person chooses not to do so o find out if someone can claim you as a dependent, see ub 0 Worksheet for Line - Dependents Who Checked One or Both boxes mount, if any, from line on front B inimum standard deduction 000 C nter the larger of Line or line B here D aximum standard deduction f single, enter $,00; if married filing jointly, enter $,00 nter the smaller of line C or line D here his is your standard deduction xemption amount f single, enter both you and your spouse can be claimed as dependents, enter only one of you can be claimed as a dependent, enter $,000,00 keep a copy for your records G dd lines and nter the total here and on line on the front f you did not check any boxes on line, enter on line the amount shown below that applies to you ingle, enter $0,00 his is the total of your standard deduction $,00 and your exemption $,000 arried filing jointly, enter $0,00 his is the total of your standard deduction $,00, your exemption $,000, and your spouse s exemption $,000 ailing return f filing by mail, send to: Division of evenue and axation Central Office inian District Office ota District Office O Box CHB O Box O Box 0 aipan, 0 inian, ota, Deadline: pril, 0 age

3 O W C orm 00Z-C Home address number and street pt no WG D LY X COUO Other C wages and salaries not included in line otal C wages and salaries dd lines and O ake sure the s above are correct YOUL C wages and salaries from orms W-C 0 lease type or print in ink H W O L CO CO D D L D UL WG D LY X U C L L H OH HO L L DVO VU D XO O H H B OU C wages and salaries ubtract line from line nnual wage and salary tax see supplemental instructions on page Combined annual wage and salary tax dd line, Columns and B 8 Wages and salary tax withheld and/or paid from orm W-C 8 otal wage and salary tax due or overpaid ubtract line 8 from line lace brackets if less than zero COL O O-0 O G - COUO O-UDBL CD D LCO O B O C OUC X BO COLG B B CH X D B CLCULO overpaid ax on overpayment of credits otal Chapter liability or overpaid dd lines, and C hird arty Designee COBD DU O OVY otal amount due or overpaid dd line of and line of B f line is an overpayment, enter amount you want credited to your 0 D X et overpaid dd lines and of this part his is your refund/rebate Yes Complete the following name no o number ign here Joint return? Keep a copy for your records aid reparer Use Only pouse s signature f a joint return, both rint/ype preparer s name irm s name irm s adress DDL: L, 0 reparer s signature check if self employed irm s hone no age

4 COOWLH H CL OH LD orm O-0 L DVO VU D XO COOWLH H OH LD COUO O-UDBL CD D LCO O B O C OUC CO X or orm 00Z-C 0 Last name Your social security number Last name pouse s social security number Home address number and street pt no ake sure the s above are correct CO D OWLH H OH O LD C - on-refundable Credits Wage and salary tax nter amount from line, art of the Wage and alary ax eturn otal nter amount from line 0 of form 00Z-C otal payments made nter amount from line of form 00Z-C ebate base ubtract the amount in art, from the amount on line of this part f zero or less, enter -0- overpayment f line is greater than line, subtract line from line Otherwise enter -0- underpayment f line is greater than line, subtract line from line Otherwise enter -0- Calculate this amount as determined by the rebate base line using the rebate table shown below B BL B B line : H B OU : XL: ot over $0,000 0% of the rebate base ebate base X 0% $0,00-00,000 $8,000 plus 0% of the rebate base over $0,000 ebate base - $0,000 X 0% + 8,000 ign Here preparer has any knowledge Keep a copy for Your ecords Your signature pouse s signature f a joint return, both must sign aid reparer Use only rint/ype preparer s name reparer s signature Check if self-employed irm s name irm s irm s address hone no age

5 ULL UCO O O 00Z-C 0 nnual Wage and alary ax, Chapter WG D LY X COUO nter total wages and salaries received for work performed in the C per orms W-C box or a joint return, enter spouse income in column B nter other wages and salaries received for work performed in the C which orms W-C were not issued or received, ie tips, freelance income, etc dd lines and in each column nter the amount not subject to the wage and salary tax ubtract line from line in each column his is your total C wages and salaries subject to the wage and salary tax Compute your wage and salary tax on the amount reported on line each column using the wage and salary tax table below dd the tax on line, columns and B and enter on this line 8 nter the total Chapter tax withheld as shown in orms W-C box lso, add other Chapter wage and salary tax payments made for wages and salaries tax due/overpaid COL O O-0 -COUO O-UDBL CD D LCO O B O C OUC X BO COLG B B CH X D B CLCULO nter amount from line of orm O-0 nter amount from line of orm O-0 nter amount from line of orm O-0 dd amounts on lines through of this part ote that lines and are negative numbers f the total on this line is less than zero, place a bracket around the figure nter the lesser of the amount on line of orm 00Z-C or the amount on line ignore bracket nter the estimated tax penalty here based on the underpaid tax shown on line of this part dd lines thru his is your total Chapter liability or overpayment f overpaid, place a bracket around the figure C COBD DU O OVY mount due or overpaid dd line of and line of B ake sure that negative amount is enclosed by parenthesis f line is an overpayment, enter amount you want credited to your 0 estimated tax et overpaid dd line and line of this part his is your refund/rebate age

DIVISION OF REVENUE AND TAXATION Department of Finance COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS Territorial Individual Income Tax Return

DIVISION OF REVENUE AND TAXATION Department of Finance COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS Territorial Individual Income Tax Return I COMMOWLH O H OICIL ORHR MRI ISLDS S L DIVISIO O RVU D XIO Department of inance COMMOWLH O H ORHR MRI ISLDS erritorial Individual Income ax Return D COMMO P WLH R M O H ORHR O MR I ISLDS C orm 100-CM