New Hampshire Small Business Corporations (S-Corp) Information R

Small Business Corporations (S-Corp) Information R
BET
DO NOT ATTACH TO RETURN

Print Form

New Hampshire

DP-9

Department of
Revenue Administration

Reset Form

*000DP92311862*
000DP92311862

SMALL BUSINESS CORPORATION ("S" CORP) INFORMATION REPORT
Name of "S" Corporation

Federal Employer ID Number

Number & Street Address

City / Town

Address (continued)

State

Total of all actual distributions made to New Hampshire residents for the period end ...............................................

Calendar Year

Zip Code + 4 (or Canadian Postal Code)

$

Shareholder Name and Address (New Hampshire Residents ONLY)
Last Name

MI

First Name

Social Security Number

Number & Street Address
Amount of Distribution
City / Town

State

Last Name

First Name

Zip Code + 4 (or Canadian Postal Code)

MI

Social Security Number

Number & Street Address
Amount of Distribution
City / Town

Last Name

State

Zip Code + 4 (or Canadian Postal Code)

First Name

MI

Social Security Number

Number & Street Address
Amount of Distribution
City / Town

State

Last Name

First Name

Zip Code + 4 (or Canadian Postal Code)

MI

Number & Street Address
City / Town

DP-9 2023
Version 1 08/2023

Social Security Number

Amount of Distribution
State

Zip Code + 4 (or Canadian Postal Code)

Page 1 of 3

New Hampshire

DP-9

Department of
Revenue Administration
Last Name

*000DP92321862*
000DP92321862

MI

First Name

Number & Street Address

Social Security Number

Amount of Distribution

City / Town

State

Last Name

First Name

Zip Code + 4 (or Canadian Postal Code)

MI

Social Security Number

Number & Street Address
Amount of Distribution
City / Town

State

Last Name

First Name

Zip Code + 4 (or Canadian Postal Code)

MI

Social Security Number

Number & Street Address
Amount of Distribution
City / Town

State

Last Name

First Name

Zip Code + 4 (or Canadian Postal Code)

MI

Social Security Number

Number & Street Address
Amount of Distribution
City / Town

State

Zip Code + 4 (or Canadian Postal Code)

If additional space is required,
attach another sheet.

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.)
Print Signatory Name & Title

Signature (in ink) of Officer

MMDDYYYY

MMDDYYYY

Signature (in ink) of Paid Preparer Other Than Taxpayer

Preparer's Tax ID Number

Print Preparer's Name

DO NOT FILE WITH BUSINESS
RETURN. MAIL UNDER SEPARATE
COVER TO ADDRESS BELOW.

Number & Street Address

FILE ONLINE AT GRANITE TAX CONNECT
WWW.REVENUE.NH.GOV/GTC

Address (continued)

City / Town

DP-9 2023
Version 1 08/2023

State

Zip Code + 4 (or Canadian Postal Code)

Or Mail To: NH DRA
PO BOX 637
CONCORD NH 03302-0637

Page 2 of 3

New Hampshire
Department of
Revenue Administration

DP-9

SMALL BUSINESS
CORPORATION ("S" CORP)
INFORMATION REPORT

INSTRUCTIONS
WHO MUST FILE
The report must be completed by every subchapter "S" corporation which has made actual or constructive distributions to its New
Hampshire shareholders during the year, per RSA 77:17-a.

WHAT TO FILE
Actual distributions from "S" corporations made to New Hampshire residents are taxable to the individual recipient under New
Hampshire Interest & Dividends Tax law. "S" corporations are required to use this form to report such distributions. Report any
actual distributions from current year or prior year accumulated profits (as defined in RSA 77 and Rev 901). Do not report the
shareholders' proportionate share of the "S" corporation's income (loss) as shown on the individual or shareholders' Federal
Schedule K-1.
NOTE: If more than 8 shareholders received actual distributions from the "S" corporation during the period, attach an additional
sheet listing the required information for each additional shareholder.

WHEN TO FILE
This report is due annually on or before May 1st, after the end of the year. Pursuant to RSA 77:17-a, a list of New Hampshire
shareholders during the preceding year together with the amount of dividends paid to each must be reported on this form.

WHERE TO FILE
File online using Granite Tax Connect at www.revenue.nh.gov/gtc or mail to NH DRA, PO Box 637, Concord, NH 03302-0637.
FORMS SHALL NOT BE FILED BY FAX OR EMAIL

DP-9 2023
Version 1 08/2023

Page 3 of 3