How to Fill Out Nebraska Form 12N: Nonresident Income Tax Agreement

Nebraska Form 12N is a one-page Nonresident Income Tax Agreement that lets a nonresident owner of a Nebraska pass-through entity opt out of automatic state withholding on their share of the entity’s income. By signing it, you commit to filing a Nebraska Individual Income Tax Return (Form 1040N) and paying the tax yourself. A new form must be signed every year and delivered to the entity before it files its Nebraska return. If you miss that window, the entity is required to withhold at the state’s highest individual income tax rate, which drops to 4.55 percent for the 2026 tax year.¹

Who Can Use Form 12N

You qualify if you were a nonresident of Nebraska during any part of the entity’s taxable year and you hold an ownership or beneficiary interest in a Nebraska pass-through entity. Eligible roles include:²

S corporation shareholders
Partners in a general or limited partnership
Members of a limited liability company
Beneficiaries of an estate or trust with Nebraska-source income
Nonresident grantors of a grantor trust

Because the form is executed fresh each year, there is no separate revocation. If you no longer want to handle the tax yourself, just don’t submit a new Form 12N for the next year, and the entity will withhold on your share going forward.²

How to Fill Out the Form

The form is available as a PDF on the Nebraska Department of Revenue website and has three parts.

Organization Information

At the top, enter the pass-through entity’s legal name, mailing address, Nebraska ID number, Federal Employer Identification Number, and tax year. Get these details directly from the entity. An incorrect FEIN or Nebraska ID can prevent the Department of Revenue from matching your agreement to the entity’s return.²

Nonresident Individual Information

Enter your full legal name, mailing address, and Social Security number. If you are married and will file jointly on your Nebraska return, include your spouse’s Social Security number as well.²

Agreement and Signature

The body of the form is a declaration that you were a nonresident for the tax year shown, that you will timely file a Form 1040N, pay any income tax due, and include your share of the entity’s Nebraska income in your Nebraska adjusted gross income. Read it before you sign. The signature creates a binding commitment to do all three. Date the form to make it valid.²

Where to Send It and When

You do not send Form 12N to the Nebraska Department of Revenue. Deliver the signed, dated form to the pass-through entity itself, whether that is a partnership, S corporation, LLC, estate, or trust, before it files its Nebraska income tax return for the year.²

For calendar-year entities, the Nebraska return date generally follows the federal deadline. S corporation returns (Form 1120-SN) and partnership returns (Form 1065N) are typically due March 15 after the close of the tax year.³ Get the form to the entity well before mid-March so the preparer has time to include it.

What the Entity Does With Your Form

The entity attaches the signed form to its Nebraska return (Form 1120-SN for S corporations, Form 1065N for partnerships). That attachment is what relieves the entity of its withholding obligation on your share of income.⁴

If the entity e-files, Form 12N does not need to be transmitted electronically with the return. The tax preparer keeps the completed form in the organization’s records, where the Department of Revenue can request it during a review or audit.²

Without a valid Form 12N, the entity must withhold and remit an amount equal to the highest individual income tax rate applied to that owner’s share of Nebraska-source income, 4.55 percent for the 2026 tax year.⁴¹

What You Owe After Signing

Signing commits you to filing a Nebraska Individual Income Tax Return, Form 1040N, for that tax year. You report your share of the entity’s Nebraska-source income in your Nebraska adjusted gross income.⁴ The filing deadline for the 2025 tax year return is April 15, 2026.⁵

Estimated Tax Payments

With nothing being withheld at the entity level, you may owe estimated tax during the year. Nebraska requires quarterly estimated payments if your state income tax liability, after personal exemption credits, is expected to exceed your withholding and other credits by $500 or more.⁶

For the 2026 tax year, the quarterly due dates are:

April 15, 2026
June 15, 2026
September 15, 2026
January 15, 2027

You can pay the full estimated amount with the first voucher or split it into four equal installments. If a due date falls on a weekend or legal holiday, you have until the next business day.⁶

Penalties if You Sign and Don’t Follow Through

Signing Form 12N and then failing to file or pay carries real consequences. The Nebraska Department of Revenue applies the following penalties to individual income tax returns:⁷

Late filing: 5 percent of the unpaid tax for each month the return is overdue, up to a 25 percent maximum.
Late or partial payment: 5 percent of the unpaid tax balance as of the due date or extended filing date.

Interest also accrues on any unpaid balance. From January 1, 2025, through December 31, 2026, Nebraska charges 8 percent per year, calculated as simple interest.⁸

1
Nebraska Legislature. Nebraska Code 77-2715.03 – Individual Income Tax Brackets and Rates
2
Nebraska Department of Revenue. Nebraska Form 12N – Nebraska Nonresident Income Tax Agreement
3
Cornell Law Institute. 316 Neb. Admin. Code, ch. 24, Section 223 – Income Tax Returns
4
Cornell Law Institute. 316 Neb. Admin. Code, ch. 24, Section 225 – Income Tax Returns; Pass-Through Entities; Income Tax Withholding From Nonresident Individual Owners
5
Nebraska Department of Revenue. Nebraska Tax Calendar
6
Nebraska Department of Revenue. Nebraska Individual Estimated Income Tax Payment Vouchers
7
Nebraska Department of Revenue. Individual Income Tax FAQs
8
Nebraska Department of Revenue. Interest Rate Assessed on State Taxes