nd.gov - The Official Portal for North Dakota State Government
North Dakota: Legendary. Follow the trail of legends

Forms

Application Forms
Reimbursement Forms
Please Remit Applications & Reimbursements to:
Energy Infrastructure and Impact Office
1707 North 9th Street
PO Box 5523
Bismarck, ND 58506-5523
Email: energyimpact@nd.gov
Fax: 701-328-3650
Office: 701-328-2800

ACH Electronic Payment Form
  • ACH Electronic Payment Authorization Form
  • Authorization Forms with a voided check or savings withdrawal slip are to be sent to:
    Vendor Registry
    600 E. Boulevard Ave.-Dept 012
    14th Floor Capitol Tower
    Bismarck, ND 58505-0310