New Hampshire Request for Department Identification Number (DIN)

Request for Department Identification Number (DIN)
DP-200 Form
Print Form

New Hampshire
Department of
Revenue Administration

DP-200

Reset Form

*0DP2002411862*
0DP2002411862

REQUEST FOR DEPARTMENT IDENTIFICATION NUMBER (DIN)
BUSINESS ENTITY INFORMATION
Business Name

DO NOT FILE THIS FORM
FOR AN SMLLC THAT ALREADY
HAS ITS OWN FEIN.

Number & Street Address
State

City / Town

Zip Code + 4 (or Canadian Postal Code)

You must use your Department Identification Number (DIN) on all of the documents filed with the DRA instead of the Federal Employer Identification Number (FEIN) or
Social Security Number (SSN).

MEMBER OR TAXPAYER INFORMATION
Taxpayer Identification Number

Member or Taxpayer Name
Number & Street Address
City / Town

ENTITY TYPE:

FEIN
State

CORPORATION

SSN

Zip Code + 4 (or Canadian Postal Code)

COMBINED GROUP

FIDUCIARY

PARTNERSHIP

PROPRIETORSHIP

For federal income tax purposes, the income of the SMLLC will be reported on the tax return of the member as listed above.
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:
Taxpayer Identification Number

Member or Taxpayer Name
Number & Street Address
City / Town

FEIN
State

SSN

Zip Code + 4 (or Canadian Postal Code)

SIGNATURE & INFORMATION
Under penalties of perjury, I declare that I have examined this document and to the best of my belief it is true, correct and complete.
Signature (in ink) of Applicant

MMDDYYYY

Print Signatory Name & Title

DP-200
Version 1 07/2024

FILE ONLINE AT GRANITE TAX CONNECT GTC.REVENUE.NH.GOV/TAP/_/
OR MAIL TO: NH DRA, PO BOX 637, CONCORD NH 03302-0637.

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