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

Small Business Corporations (S-Corp) Information R
DP-9 Form
DO NOT ATTACH TO RETURN

Print Form

New Hampshire

*000DP92411862*

DP-9

Department of
Revenue Administration

Reset Form

000DP92411862

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
Version 1 07/2024

Social Security Number

Amount of Distribution
State

Zip Code + 4 (or Canadian Postal Code)

Page 1 of 2

New Hampshire

DP-9

Department of
Revenue Administration
Last Name

*000DP92421862*
000DP92421862

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

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
gtc.revenue.nh.gov/TAP/_/

Address (continued)

City / Town

DP-9
Version 1 07/2024

State

Zip Code + 4 (or Canadian Postal Code)

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

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