New Hampshire General Tax Payment Voucher

General Tax Payment Voucher
nh-pyt-2016.pdf
New Hampshire
Department of
Revenue Administration

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Payment
Voucher

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*0NHPYT2311862*
0NHPYT2311862

INSTRUCTIONS
Select the tax type for which the payment applies.
For a Business Tax or Interest and Dividend Tax payment, select the appropriate entity type. For Meals and Rentals (M&R) Tax,
select All Entity Types.
3 Enter the beginning and ending date of the taxable period for which the payment applies.
4 Select the Taxpayer Identification Number type (Social Security Number (SSN), Federal Employer Identification Number (FEIN),
Department Identification Number (DIN), or M&R License Number) and enter number. For a Joint entity type, please enter
Identification Number of the primary filer.
5 Enter the amount paid.
6 Enter the taxpayer's name and address. For a joint entity type, please enter the information for the primary filer.
1
2

Make your check payable to: STATE OF NEW HAMPSHIRE
Do not staple or tape the voucher and check together.
If you are making payments for multiple tax periods or multiple tax types, please provide a voucher for each tax period and each tax
type and indicate the amount you wish to be applied to each tax period and each tax type.
Mail this voucher with your payment to:
NH DRA
PO BOX 1265
CONCORD, NH 03302-1265

Pay online at Granite Tax Connect
www.revenue.nh.gov/gtc

Need Help? Call the Department at (603) 230-5920, Monday through Friday, 8:00am - 4:30pm
DO NOT CUT
1 Tax Type
2 Entity Type
Business

Corporation

Combined

Partnership

Interest & Dividends

Individual/Joint

Partnership

Estate

Meals & Rentals

All Entity Types
MMDDYYYY

3 Taxable period beginning:
4

DIN

Taxpayer Name
Last Name

Fiduciary

Non-Profit

MMDDYYYY

and ending:

Taxpayer Identification #
FEIN

Proprietorship

5 Amount Paid
SSN

M&R License Number

6

MI

First Name

Business Name

Number & Street Address
Address (continued)

City / Town

NH-PYT
Version 1.1 10/2023

State

Zip Code + 4 (or Canadian Postal Code)