Form Cd-100 - Meals & Rentals Request To Update Or Change License

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FORM
NEW HAMPSHIRE DEPARTMENT OF REVENUE ADMINISTRATION
CD-100
MEALS & RENTALS REQUEST TO
License Update
UPDATE OR CHANGE LICENSE
TAXPAYER'S LICENSE # ___ ___ ___ ___ ___ ___
(ENTER LICENSE NUMBER)
NOTICE IS HEREBY GIVEN to the New Hampshire Department of Revenue Administration that the taxpayer named in item No. 1 below is
requesting the following change in fi ling requirements and/or providing the updated changes as prescribed in RSA 78-A.
1. BUSINESS NAME
2. CORPORATE NAME, PARTNER NAMES OR PROPRIETOR'S NAME
3. NUMBER & STREET ADDRESS OF BUSINESS LOCATION
4. ADDRESS (continued)
6. PHONE NUMBER
5. CITY/STATE/ ZIP CODE
5(a). MAILING ADDRESS, IF DIFFERENT FROM PHYSICAL ADDRESS
CHANGE IN BUSINESS STATUS (by location):
You must surrender your current Meals & Rentals Tax License with this form if you have checked lines 7, 8, 9, or 11.
Business at this location suspended or discontinued entirely, without a new owner ......................................... DATE ___________________
7.
Business at this location continued without taxable sales as of ........................................................................ DATE ___________________
8.
Business at this location was acquired by a new owner as of ........................................................................... DATE ___________________
9.
NAME OF NEW OWNER:
ADDRESS OF NEW OWNER:
Business NAME change (not a new owner) at this location as of ..................................................................... DATE ___________________
10.
NEW BUSINESS NAME:
Business moved to a new location (not a new owner) as of.............................................................................. DATE ___________________
11.
NEW LOCATION:
NOTE: You must submit Form CD-3 to request a new Meals & Rentals Tax License.
REQUEST FOR CHANGE IN FILING REQUIREMENTS
12.
_
I request my fi ling requirements be changed:
FROM:
month beginning
month ending
_
TO:
month beginning
month ending
I understand a return must be fi led for each month in which sales are incurred. I also understand that a return must be fi led for each month in
which my license is active, even though there may be no tax due.
X
FOR DRA USE ONLY
SIGNATURE (IN INK)
PRINTED SIGNATORY NAME & TITLE
DATE
NH DRA
MAIL
TO:
COLLECTION DIVISION
PO BOX 454
CONCORD NH 03302-0454
CD-100 License Update
Rev 02/2011

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