Form Au-208 - Qualified Investment Company (Qic) Report
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1NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
FORM
QUALIFIED INVESTMENT COMPANY (QIC) REPORT
AU-208
Instructions
GENERAL INSTRUCTIONS
WHO MUST FILE
STEP BY STEP INSTRUCTIONS
A business organization that elects qualifi ed investment company (QIC)
status for the stated taxable period (and all succeeding taxable periods
STEP 1
until the election is terminated) is required to annually fi le this report
Enter the name, address and Federal Employer Identifi cation Number
with the Department.
or Department Identifi cation Number of the business organization
submitting this report in the spaces provided.
WHAT TO FILE
This report completed through Step 6, OR, the report with Step 1, Step 5
STEP 2
and Step 6 completed accompanied by a copy of the QIC federal income
Enter the aggregate amount of funds invested in the QIC as of the period
tax return fi led with the Internal Revenue Service for the taxable period,
end; the names, addresses, Federal Employer Identifi cation Numbers or
shall be fi led with the Department.
Social Security Numbers of holders of the company and their proportional
share of income.
WHEN TO FILE
The report, along with a copy of the QIC federal income tax return, if such
STEP 3
fi ling method is chosen, must be fi led with the Department on or before
Enter the name, address and Federal Employer Identifi cation Number
30 days following the fi ling of the QICs federal income tax return with the
of the manager of the QIC, if any.
Internal Revenue Service for the taxable period.
STEP 4
WHERE TO FILE
Enter the amount of income received and expenses incurred by the QIC
The report and accompanying documents, if applicable, shall be mailed
in the taxable period. Attach supporting schedules as necessary.
to the NH Department of Revenue Administration, Audit Division, 109
Pleasant Street, PO Box 457, Concord, NH 03302-0457.
STEP 5
Check the box in Step 5 only if a copy of the federal return is being
PENALTY FOR FAILURE TO TIMELY FILE REPORT
submitted with this report.
Any QIC which fails to timely fi le the report as required by RSA 77-A:5-b,II
shall pay a penalty equal to $100 for each day such report is not fi led,
STEP 6
unless an extension has been granted by the Commissioner. In no event
Signature of the duly authorized representative (in ink) . Indicate the title
shall the monetary fi ne imposed exceed $5,000. A QIC notifi ed by the
of the representative and the date. If the report is prepared by someone
Department that such report is overdue by more than 50 days shall have
other than the duly authorized representative please sign, in ink, and give
30 days from the date of such notifi cation to fi le the delinquent report.
Federal Employer Identifi cation Number, address and the date.
If the delinquent report is not fi led within 30 days after notifi cation, the
Commissioner shall disallow the business organization's QIC status for
-OR-
any taxable period for which a timely report has not been fi led.
STEP 1
RECORD KEEPING
Enter the name, address and Federal Employer Identifi cation Number
All of the normal tax administration powers given to the Department with
or Department Identifi cation Number of the business organization
respect to other taxes and taxpayers are also applicable to QICs. In
submitting this report in the spaces provided.
accordance with the provisions of RSA 77-A:5-b, IV, QICs are subject to
the requirements of RSA 77-A:11 and RSA 77-E:10. Such organizations
STEP 2 - 4
must comply with the standard record keeping and availability of records
Attach a copy of federal income tax return as fi led with the Internal
for audit requirements that apply to other NH business taxpayers.
Revenue Service for the taxable period.
NEED HELP?
STEP 5
For more information concerning this report you may call the Audit
Indicate by checking the box that the federal return is being submitted
Division at (603) 271-3400.
with this report.
NEED FORMS?
STEP 6
To obtain the form needed to fi le this report visit our web site at
Signature of the duly authorized representative (in ink) . Indicate the title
, or call the forms line at (603) 271-2192.
of the representative and the date. If the report is prepared by someone
other than the duly authorized representative please sign, in ink, and give
Federal Employer Identifi cation Number, address and the date.
AU-208
Instructions
Rev 02/2011
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