New Hampshire Interest and Dividends Tax Return

Interest and Dividends Tax Return
DP-10
Print Form

DO NOT STAPLE
New Hampshire

2023

Department of
Revenue Administration

Reset Form

*00DP102311862*

DP-10

00DP102311862

INTEREST AND DIVIDENDS TAX RETURN
MMDDYYYY

MMDDYYYY
For the CALENDAR year 2023 or other taxable period beginning:

STEP 1 - PRINT OR TYPE

and ending:

Check box if there has been a name change since last filing.

Last Name

First Name

MI

Social Security Number

Spouse's Last Name

First Name

MI

Due Date for CALENDAR
year filers is on or before
April 15, 2024
Due Date for FISCAL year
filers is the 15th day of the
4th month after
the close of the
taxable period.
If you have a DIN, use the DIN
in the taxpayer ID box.
DO NOT use FEIN or SSN
Taxpayer Identification Number

Social Security Number

Name of Partnership, Estate, or LLC

Number & Street Address

Address (continued)

Unit Type

State

City / Town

STEP 2 - Return Type

Zip Code + 4 (or Canadian Postal Code)

% of NEW HAMPSHIRE Ownership
Interest in Entity Type

ENTITY TYPE - Check One
1 - INDIVIDUAL

1 - JOINT

3 - PARTNERSHIP/LLC

4 - ESTATE

MMDDYYYY

Date of Death
Established NH Residency

INITIAL RETURN
MMDDYYYY
FINAL RETURN

AMENDED RETURN

DP-10 2023
Version 1.1 11/2023

Unit #

FINAL DECEASED
Social Security Number

Abandoned NH Residency
IRS ADJUSTMENT: A complete federal Revenue Agent Report (RAR) with all applicable Schedules must be included with a complete amended NH
tax return. Do not use this form to report IRS adjustments for taxable periods ending on or before December 31, 2020.

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New Hampshire
Department of
Revenue Administration

2023

*00DP102321862*

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INTEREST AND DIVIDENDS TAX RETURN - continued
STEP 3 - Read instructions before you begin
INTEREST & DIVIDENDS FROM ALL SOURCES
1

From Your Federal Income Tax Return: (See Instructions)
(a) Interest Income. Enter the amount from Line 2(b) of your federal return

1(a)

(b) Dividend Income. Enter the amount from Line 3(b) of your federal return

1(b)

(c) Federal Tax-Exempt Interest Income. Enter the amount from Line 2(a) of your federal return

1(c)

(d) Subtotal Interest and Dividends Income. (Sum of Lines 1(a), 1(b) and 1(c))
2

Round to the nearest whole dollar

Subtotal 1(d)

List Taxable Annuities or Actual Cash & Property Distributions From S-Corporations, Trusts/Estates, Partnerships, and LLCs:
Entity Codes: 2 = S-CORPORATIONS; 3 = PARTNERSHIPS;
I
Entity Code

4 = TRUSTS OR ESTATES;

II
Name of Payor

5 = LLC;

6 = FOUNDATIONS;

7 = OTHER

III
Payor's ID Number

IV
Distribution Amount

Total from supplemental schedule attached

2

Total Distributions (Sum of Column IV above)

3

Subtotal Gross Interest and Dividends Income and Distributions (Line 1(d) plus Line 2)

4

List payors and amounts of interest and/or dividends NOT TAXABLE to New Hampshire included on Lines 1(a), 1(b), 1(c) and/or 2:
I
Reason Code

2

II
Name of Payor

III
Payor's ID Number

(a) Subtotal of non-taxable income above (Sum of Column IV)

4(a)

(b) Total non-taxable income from supplemental schedule (Attached)

4(b)

(c) Non-taxable income (Subtotal of Lines 4(a) plus 4(b))

4(c)

(d) Part-year resident non-taxable income pro rata share

4(d)

DP-10 2023
Version 1.1 11/2023

Subtotal 3

IV
Non-Taxable Amount

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New Hampshire
Department of
Revenue Administration

2023
DP-10

*00DP102331862*
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INTEREST AND DIVIDENDS TAX RETURN - continued
STEP 3 - (continued) Read instructions before you begin
INTEREST & DIVIDENDS FROM ALL SOURCES
4

Total Non-Taxable Income (Sum of Line 4(c) plus Line 4(d))

5

Gross Taxable Income (Line 3 minus Line 4)

6

Less: $2,400 for Individual, Partnership and Estate; $4,800 for Joint filers

7

Adjusted Taxable Income (Line 5 minus Line 6) If less than zero, use minus sign.

Round to the nearest whole dollar
4

5
6
7

Year of Birth
Blind

Spouse Blind

Check the exemptions that apply. Total number of boxes checked

9

Net Taxable Income (Line 7 minus Line 8). If less than zero, use minus sign.

DP-10 2023
Version 1.1 11/2023

Spouse 65 (or over) or disabled

65 (or over) or disabled

8

Year of Birth

x $1200 =

8
9

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New Hampshire

2023

Department of
Revenue Administration

DP-10

*00DP102341862*
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INTEREST AND DIVIDENDS TAX RETURN - continued
STEP 4 - Calculate Your Tax, Credits, Interest and Penalties
10

New Hampshire Interest and Dividends Tax
(Line 9 multiplied by 4%)

11

RSA 77-G Education Tax Credit

Round to the nearest whole dollar
10

11

12 New Hampshire Interest and Dividends Tax Net of Education Tax
Credit (Line 10 minus Line 11. If negative enter zero)

13

Payments:
(a) Tax paid with application for extension

13(a)

(b) Current year estimated tax payments

13(b)

(c) Credit carryover from prior tax period

13(c)

12

13 Subtotal of Lines 13(a) through 13(d)
(d) Paid with original return (Amended returns only)
14

13(d)

Subtotal Due (Line 12 minus Line 13 Subtotal)

14

15 Additions to Tax:
(a) Interest

15(a)

(b) Failure to Pay

15(b)

(c) Failure to File

15(c)
15 Subtotal of Lines 15(a) through 15(d)

(d) Underpayment of Estimated Tax

15(d)

STEP 5 - Calculate Your Net Balance Due or Overpayment
16

(a) Subtotal Due (Line 14 plus Line 15 Subtotal)

16(a)

(b) Return Payment Made Electronically

16(b)

17 Net Balance Due (Line 16(a) minus Line 16(b))
(Make Check Payable to State of New Hampshire)
18 OVERPAYMENT
(If balance due is less than zero, enter on Line 18)

17

18

19 Amount of Line 18 to be applied to:
(a) Credit - Next Year's Tax Liability (Not available for Federal RAR)
(b) Refund (Only option available for Federal RAR)

DP-10 2023
Version 1.1 11/2023

PAY THIS AMOUNT

19(a)

DO NOT PAY

19(b)

DO NOT PAY

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New Hampshire
Department of
Revenue Administration

2023

*00DP102351862*

DP-10

00DP102351862

INTEREST AND DIVIDENDS TAX RETURN - continued
Under penalties of perjury, I declare that I have examined this return and to the best of my belief it is true, correct and complete. If
prepared by a person other than the taxpayer, this declaration is based on all information of which the preparer has knowledge.

POA: By checking this box and signing below, you authorize us to discuss this return with the preparer listed below.
TAXPAYER'S SIGNATURE & INFORMATION
Signature (in ink)

MMDDYYYY

If joint return, BOTH parties must sign, even if only one had income

MMDDYYYY

Print Signatory Name(s) (and Title if applicable)

Taxpayer's Phone Number
Form 1310 attached

Filing as surviving spouse

PAID PREPARER'S SIGNATURE & INFORMATION
Signature of Preparer

MMDDYYYY

Printed Name of Preparer

Preparer's Phone Number

Preparer Identification Number

Preparer's Address

City / Town

Mail to:
NH DRA
PO Box 637
Concord NH 03302-0637

DP-10 2023
Version 1.1 11/2023

State

Make Check Payable to:
STATE OF NEW HAMPSHIRE
Enclose but DO NOT staple or tape your
attachments

Zip Code + 4 (or Canadian Postal Code)

FILE ONLINE AT GRANITE TAX CONNECT
www.revenue.nh.gov/gtc

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