This document is a form from the New Hampshire Department of Revenue Administration for reporting an address change. The form has sections to select the entity type and tax type, and to provide both the prior and new mailing addresses. It includes fields for the business or individual name, street address, city, state, zip code, and phone number. It must be signed and dated by the taxpayer or a corporate officer to certify they have authority to report the address change.

1. NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
FORM
DP-100 REPORT OF ADDRESS CHANGE
FOR DRA USE ONLY
Print and Reset Form
CHECK ONE TYPE FROM EACH COLUMN (A & B)
A: ENTITY TYPE B: TAX TYPE
Corporation Business Profits & Business Enterprise Tax
Combined Filer
Proprietorship Interest & Dividends
Fiduciary
Non-Profit Other Tax Type:
Partnership
Individuals (for Interest & Dividends filers only)
Not for use for Meals & Rentals Tax or Communications Services Tax.
Meals & Rentals Operators use Form CD-100.
Communications Services Tax use Form DP-144.
PRIOR MAILING ADDRESS
BUSINESS NAME
PROPRIETOR'S NAME or INDIVIDUAL NAME
NUMBER & STREET ADDRESS
ADDRESS (continued)
CITY/TOWN, STATE & ZIP CODE
NEW MAILING ADDRESS
BUSINESS NAME
PHONE NUMBER
PROPRIETOR'S NAME or INDIVIDUAL NAME
NUMBER & STREET ADDRESS
ADDRESS (continued)
CITY/TOWN, STATE & ZIP CODE
If signed by a corporate officer or fiduciary on behalf of the taxpayer, I certify that I have the authority to sign this address change on behalf of
the taxpayer.
x
FOR DRA USE ONLY
SIGNATURE (IN INK) DATE
x
PRINT NAME & TITLE DATE
NH DRA
MAIL
PO BOX 637
TO:
CONCORD NH 03302-0637
DP-100
Address Change
Rev. 09/2008
page 105