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    FORM                        NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
DP-200                 REQUEST FOR DEPARTMENT IDENTIFICATION NUMBER (DIN)
    980                                 INSTRUCTIONS                                                                       FOR DRA USE ONLY



 WHO MUST REQUEST A DIN                                                        WHEN TO FILE
 Any taxpayer who shares a taxpayer identiļ¬cation number with another          This form must be ļ¬led at least 30 days prior to the due date of your ļ¬rst
 taxpayer subject to taxation, any taxpayer who is not required to obtain a    business tax document. Any changes in the registration information must
 federal taxpayer identiļ¬cation number or social security number, or any       be provided to the Department at least 30 days prior to the change.
 taxpayer electing to obtain a DIN for New Hampshire in lieu of their FEIN
                                                                               WHERE TO FILE
 or SSN. Each taxpayer must have a unique federal or state taxpayer
 identiļ¬cation number. An SMLLC shall not use a SSN.                           NH Department of Revenue Administration, Document Processing
                                                                               Division, PO Box 637, Concord NH 03302-0637
 PURPOSE
                                                                                             FORMS MAY NOT BE FILED BY FAX
 To obtain an identifying number which is required to ļ¬le New Hampshire tax
 related documents. SMLLC's are required by New Hampshire Law to ļ¬le a
                                                                               NEED HELP?
 separate entity tax return even though the SMLLC does NOT ļ¬le a separate
 federal tax return. If the SMLLC shares a tax identiļ¬cation number with       Call the Department of Revenue Administration, Central Taxpayer Services
 another entity, a New Hampshire Department of Revenue Administration          at (603) 271-2191. Individuals with hearing or speech impairments may
 assigned number, Department Identiļ¬cation Number (DIN), is necessary          call TDD Access: Relay NH 1-800-735-2964.
 in order to process all tax related documents for taxpayers as described
 in quot;Who Must Request a DINquot; above.
                                                             BUSINESS ENTITY INFORMATION
BUSINESS NAME


BUSINESS NUMBER & STREET ADDRESS
                                                                                                                              FOR DRA USE ONLY
                                                                                                                                    DIN
BUSINESS ADDRESS (continued)


BUSINESS CITY/TOWN, STATE & ZIP CODE



SMLLC's and taxpayers electing to obtain a DIN, MUST USE THE DEPARTMENT IDENTIFICATION NUMBER WHEN FILING ANY AND ALL TAX
RELATED DOCUMENTS.
Your Department assigned number shall be used in place of the member's federal employer identiļ¬cation number or social security number.
When ļ¬ling all future documents, the department identiļ¬cation number shall be entered wherever federal employer identiļ¬cation numbers
or social security numbers are required.
                                                MEMBER OR TAXPAYER INFORMATION
MEMBER OR TAXPAYER NAME                                                                                            MEMBER'S SOCIAL SECURITY NUMBER OR
                                                                                                                   FEDERAL IDENTIFICATION NUMBER

MEMBER OR TAXPAYER NUMBER & STREET ADDRESS


ADDRESS (continued)


MEMBER OR TAXPAYER CITY/TOWN, STATE & ZIP CODE



                                                                                                                                    4    Fiduciary
                      1   Proprietorship                 2    Corporation/Combined Group               3   Partnership
ENTITY TYPE:

    Yes, for federal income tax purposes, the income of the SMLLC will be reported on the tax return of the member as listed above.
     No, for federal income tax purposes, the income of the SMLLC will NOT be reported on the tax return of the member as listed above.
     THE INCOME WILL BE REPORTED ON THE TAX RETURN FOR:
                                                                                                                   SOCIAL SECURITY NUMBER OR FEDERAL
NAME
                                                                                                                   IDENTIFICATION NUMBER

NUMBER & STREET ADDRESS


ADDRESS (continued)


CITY/TOWN, STATE & ZIP CODE


 Under penalties as provided by law, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct and
 complete.
                      x
 FOR DRA USE ONLY
                       SIGNATURE (IN INK) OF APPLICANT                                                                                  DATE

                      xSIGNATURE (IN INK) OF OFFICER OF CORPORATION IF OTHER THAN OWNER                                                 DATE



                       PRINT SIGNATORY NAME & TITLE


                               MAIL NH DRA
                               TO: PO BOX 637
                                    CONCORD NH 03302-0637
                                                                                                                                                   DP-200
                                                                                                                                                 Rev. 09/2008
                                                                        page 106

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Request for Department Identification Number (DIN)

  • 1. Print and Reset Form FORM NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION DP-200 REQUEST FOR DEPARTMENT IDENTIFICATION NUMBER (DIN) 980 INSTRUCTIONS FOR DRA USE ONLY WHO MUST REQUEST A DIN WHEN TO FILE Any taxpayer who shares a taxpayer identiļ¬cation number with another This form must be ļ¬led at least 30 days prior to the due date of your ļ¬rst taxpayer subject to taxation, any taxpayer who is not required to obtain a business tax document. Any changes in the registration information must federal taxpayer identiļ¬cation number or social security number, or any be provided to the Department at least 30 days prior to the change. taxpayer electing to obtain a DIN for New Hampshire in lieu of their FEIN WHERE TO FILE or SSN. Each taxpayer must have a unique federal or state taxpayer identiļ¬cation number. An SMLLC shall not use a SSN. NH Department of Revenue Administration, Document Processing Division, PO Box 637, Concord NH 03302-0637 PURPOSE FORMS MAY NOT BE FILED BY FAX To obtain an identifying number which is required to ļ¬le New Hampshire tax related documents. SMLLC's are required by New Hampshire Law to ļ¬le a NEED HELP? separate entity tax return even though the SMLLC does NOT ļ¬le a separate federal tax return. If the SMLLC shares a tax identiļ¬cation number with Call the Department of Revenue Administration, Central Taxpayer Services another entity, a New Hampshire Department of Revenue Administration at (603) 271-2191. Individuals with hearing or speech impairments may assigned number, Department Identiļ¬cation Number (DIN), is necessary call TDD Access: Relay NH 1-800-735-2964. in order to process all tax related documents for taxpayers as described in quot;Who Must Request a DINquot; above. BUSINESS ENTITY INFORMATION BUSINESS NAME BUSINESS NUMBER & STREET ADDRESS FOR DRA USE ONLY DIN BUSINESS ADDRESS (continued) BUSINESS CITY/TOWN, STATE & ZIP CODE SMLLC's and taxpayers electing to obtain a DIN, MUST USE THE DEPARTMENT IDENTIFICATION NUMBER WHEN FILING ANY AND ALL TAX RELATED DOCUMENTS. Your Department assigned number shall be used in place of the member's federal employer identiļ¬cation number or social security number. When ļ¬ling all future documents, the department identiļ¬cation number shall be entered wherever federal employer identiļ¬cation numbers or social security numbers are required. MEMBER OR TAXPAYER INFORMATION MEMBER OR TAXPAYER NAME MEMBER'S SOCIAL SECURITY NUMBER OR FEDERAL IDENTIFICATION NUMBER MEMBER OR TAXPAYER NUMBER & STREET ADDRESS ADDRESS (continued) MEMBER OR TAXPAYER CITY/TOWN, STATE & ZIP CODE 4 Fiduciary 1 Proprietorship 2 Corporation/Combined Group 3 Partnership ENTITY TYPE: Yes, for federal income tax purposes, the income of the SMLLC will be reported on the tax return of the member as listed above. No, for federal income tax purposes, the income of the SMLLC will NOT be reported on the tax return of the member as listed above. THE INCOME WILL BE REPORTED ON THE TAX RETURN FOR: SOCIAL SECURITY NUMBER OR FEDERAL NAME IDENTIFICATION NUMBER NUMBER & STREET ADDRESS ADDRESS (continued) CITY/TOWN, STATE & ZIP CODE Under penalties as provided by law, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct and complete. x FOR DRA USE ONLY SIGNATURE (IN INK) OF APPLICANT DATE xSIGNATURE (IN INK) OF OFFICER OF CORPORATION IF OTHER THAN OWNER DATE PRINT SIGNATORY NAME & TITLE MAIL NH DRA TO: PO BOX 637 CONCORD NH 03302-0637 DP-200 Rev. 09/2008 page 106