Form Dp-149 - Web Import Registration For E-File Tax Payments - 2011

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FORM
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
DP-149
WEB IMPORT REGISTRATION FOR e-FILE
NEW HAMPSHIRE TAX PAYMENTS
981
GENERAL INSTRUCTIONS
FOR DRA USE ONLY
WHO MUST REGISTER
WHEN TO REGISTER
Anyone wishing to make payments for clients. If at any time you
This form must be fi led prior to your fi rst fi le import. Any changes in
change your Tax Identification Number you must re-register with
the registration information must be provided to the Department. A
the Department and redefi ne your fi le layout under your new Tax
notifi cation letter will be sent confi rming your Tax Identifi cation Number.
Identifi cation Number.
Please allow up to 30 days for processing time, prior to using
e-File New Hampshire.
WHAT TO REGISTER
If you wish to participate in the Web Import e-File New Hampshire
WHERE TO REGISTER
program, you must submit this form to register with the Department.
New Hampshire Department of Revenue Administration, Document
The information provided on this form should include the name,
Processing Division, 109 Pleasant Street, PO Box 1004, Concord, NH
address, e-mail address, telephone number, and fax number of the
03302-1004.
contact person(s) for Web Import e-File New Hampshire purposes.
In addition, this form should be used to report any changes in your
NEED HELP?
registration information (i.e. a change to the contact person, telephone
Call the New Hampshire Department of Revenue Administration, Central
number, etc.).
Taxpayer Services at (603) 271-2191. Hearing or speech impaired
individuals may call TDD Access: Relay NH 1-800-735-2964. Access
TAX IDENTIFICATION NUMBER
our website at to try out the on-line demonstration
Please list your Practitioner Tax Identifi cation Number (PTIN). If you
of the NH e-fi le process prior to registering and to access the NH e-fi le
do not have a PTIN, please list your Federal Employer Identifi cation
system after the Department has processed your registration request.
Number (FEIN). If you do not have either a PTIN or FEIN, please list
your Department Identifi cation Number (DIN). If you do not have either
a PTIN, FEIN, or DIN please list your Social Security Number (SSN).
You will need to use one of these numbers when you make payments
for clients.
WEB IMPORT REGISTRATION FOR E-FILE NEW HAMPSHIRE TAX PAYMENTS
Please check one
PTIN
FEIN
DIN
SSN
PRINT OR TYPE
TAX PRACTITIONER/BUSINESS NAME
TAX IDENTIFICATION NUMBER
NUMBER & STREET ADDRESS
TELEPHONE
(
)
ADDRESS (CONTINUED)
CITY/ TOWN
STATE
ZIP CODE+4
TELEPHONE
CONTACT PERSON
(
)
FAX NUMBER
E-MAIL ADDRESS
(
)
Please check one of the following:
New Registration
Change Request
If changing your Tax Identifi cation Number, please provide your former Tax Identifi cation Number: _________________________________________
FOR DRA USE ONLY
AUTHORIZED REPRESENTATIVE’S SIGNATURE (IN INK)
DATE
FOR DRA USE ONLY
NH DEPT OF REVENUE ADMINISTRATION
Approved by
MAIL
DOCUMENT PROCESSING DIVISION
TO:
PO BOX 1004
Date
CONCORD NH 03302-1004
DP-149
Rev 02/2011

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