# Form 12N — Nebraska 12N: a nonresident’s agreement to file Form 1040N

- **Canonical URL:** https://formspedia.com/us/nebraska-12n/
- **Country & Language:** United States (`en-US`)
- **Form:** Form 12N
- **Revision:** 8-065-2023; directory listed 01/2024
- **Issuing Agency:** Nebraska Department of Revenue
- **Tax Area:** Business and corporate tax
- **Who Must File:** Nonresident individual beneficiaries, members, partners, shareholders and grantors, subject to the entity-election exception
- **Filing Method:** Deliver annually to the organization before its Nebraska return; attach for paper filing or retain for e-filing
- **Filing Deadline:** Before the organization files its Nebraska return
- **Official Form PDF:** https://revenue.nebraska.gov/sites/default/files/doc/tax-forms/2023/incometax/f_12N_2023_final.pdf

Complete Nebraska Form 12N with the individual, organization and matching tax periods. Check the PTET exception, annual signature and organization filing route.

This guide follows 8-065-2023; directory listed 01/2024, checked against the official documents on 30 October 2026.

### Who can sign and when the entity election excludes 12N

An individual who was a Nebraska nonresident during any part of an estate, trust, S corporation, partnership or LLC’s tax year may sign Form 12N. This includes a nonresident grantor of a grantor trust. The agreement commits the individual to timely file Form 1040N and pay Nebraska tax on the attributable income.

Do not file 12N if the entity elected to be subject to Nebraska income tax for that year. That election is available to partnerships and S corporations. Establish the entity’s election status before asking the owner to sign.

The current official forms directory links the copy numbered 8-065-2023 and lists it as 01/2024. Its taxable-period fields are blank; the 2023 filename does not make those fields a preprinted 2023 tax year.

### How to complete both identities and tax periods

Complete both sides of the identity area and match the individual tax year to the organization’s year end. The marked frames identify the two identities and the individual signature.

| Field group | Information to supply |
| --- | --- |
| Individual or grantor | Name, street or other mailing address, city, state and ZIP; individual SSN and spouse SSN in their separate fields. |
| Organization | Doing-business-as name and legal name, mailing address, city, state and ZIP; Nebraska ID and federal ID. |
| Organization’s taxable year | Beginning and ending dates, including years. |
| Nonresident’s taxable year | Beginning and ending dates of the individual year that includes the organization’s year-end date. |
| Organization type | Check only one: estate or trust, S corporation, partnership, or limited liability company. |
| Agreement | Signature of the nonresident beneficiary, member, partner or shareholder, and date. |

The numbered illustration frames identify the individual details, organization details and agreement signature; they are editorial markers, not official line numbers. Leave the area marked “Please Do Not Write In This Space” blank.

The nonresident individual signs the declaration, not an organization officer merely signing for the entity. The declaration binds heirs, representatives, assignees, successors, executors and administrators. Keep a copy of the actual signed period-specific agreement.

### When and where to deliver the annual agreement

Prepare and sign a new agreement each year and deliver it to the organization before it files its Nebraska income tax return. Do not mail it as a stand-alone individual return to DOR. For paper filing, the organization attaches it to its return. For e-filing, the organization retains it in its records and the preparer retains the required completed agreement.

The form gives the estate and trust return due date as the 15th day of the fourth month after the tax year closes. For S corporations, partnerships and LLCs filing as either, it gives the 15th day of the third month. Arrange delivery before the actual filing; the agreement does not provide an extension.

The signer must timely file 1040N, reporting both the organization’s Nebraska income attributable to the interest and other Nebraska-source income. If the individual and organization use different tax years, report the share in the individual year containing the organization’s year-end date.

### What happens without a completed 12N

Without a properly completed agreement attached to a paper return or retained for e-filing, the organization generally must report and remit tax using the highest individual income tax rate applicable to that year on the nonresident’s Nebraska-source share. Report withholding on Schedule K-1N and the entity return. The individual claims the remittance as a credit when filing 1040N. A fixed rate from another year can produce the wrong payment.

If the nonresident has no other Nebraska-source income, the organization filed Schedule K-1N and remitted the appropriate amount, the form’s no-agreement instructions permit the individual not to file 1040N. DOR keeps the payment in full satisfaction of that obligation; the individual may still file to claim a refund. This exception does not cancel the filing commitment made by signing 12N.

Publicly traded partnerships are exempt from the remittance provision described here. Estates and trusts can reconcile beneficiary income and withholding with [Schedule K-1N for Form 1041N](/us/nebraska-k-1n-1041n/). Retain the annual agreement, K-1N and payment evidence with the return records.

### Official sources and review date

- [Nebraska Nonresident Income Tax Agreement](https://revenue.nebraska.gov/sites/default/files/doc/tax-forms/2023/incometax/f_12N_2023_final.pdf)
- [Corporation and S Corporation Income Tax Forms | Nebraska Department of Revenue](https://revenue.nebraska.gov/about/forms/corporation-and-s-corporation-income-tax-forms)