Form Dp-144 - Communications Services Tax Registration Change Request
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1FORM
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
DP-144
COMMUNICATIONS SERVICES TAX
REGISTRATION CHANGE REQUEST
CST Change
After completing the applicable section below, detach this form from the booklet and remit to address at the bottom of page.
CHANGE FROM:
COMPANY/RESLLER
COMPANY/RESELLER NAME
COMMUNICATIONS TAX REGISTRATION NUMBER
CORPORATE NAME, PARTNER NAMES OR PROPRIETOR'S NAME
FEDERAL EMPLOYER IDENTIFICATION NUMBER
NUMBER & STREET ADDRESS
SOCIAL SECURITY NUMBER
ADDRESS (continued)
CITY/TOWN
STATE & ZIP CODE+4
CHANGE TO:
COMMUNICATIONS TAX REGISTRATION NUMBER
COMPANY/RESELLER NAME
FEDERAL EMPLOYER IDENTIFICATION NUMBER
CORPORATE NAME, PARTNER NAMES OR PROPRIETOR'S NAME
SOCIAL SECURITY NUMBER
NUMBER & STREET ADDRESS
ADDRESS (continued)
CITY/TOWN
STATE & ZIP CODE+4
CHANGE FROM:
AGENT MAILING ADDRESS
FEDERAL EMPLOYER IDENTIFICATION NUMBER
AGENT NAME
NUMBER & STREET ADDRESS
ADDRESS (continued)
CITY/TOWN
STATE & ZIP CODE+4
CHANGE TO:
FEDERAL EMPLOYER IDENTIFICATION NUMBER
AGENT NAME
NUMBER & STREET ADDRESS
ADDRESS (continued)
CITY/TOWN
STATE & ZIP CODE+4
COMPANY/RESELLER NAME CHANGE OR ENTITY CHANGE
CHANGE FROM:
TO:
COMMUNICATIONS SERVICES TAX REGISTRATION NUMBER:
Under penalties of perjury, I declare that I have examined this document and to the best of my belief it is true, correct and complete.
FOR DRA USE ONLY
I understand a return must be fi led for each month, even though there may be no tax due.
SIGNATURE (IN INK) OF RESELLER (PROPRIETOR, PARTNER OR CORPORATE OFFICER)
DATE
NH DRA
AUDIT DIVISION
PRINT SIGNATORY NAME & TITLE
MAIL
PO BOX 457
TO:
CONCORD NH 03302-0457
DP-144
Rev 02/2011
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