DO NOT STAPLE 2023 DP-10 New Hampshire Department of Revenue Administration INTEREST AND DIVIDENDS TAX RETURN MMDDYYYY MMDDYYYY For the CALENDAR year 2023 or other taxable period beginning: and ending: STEP 1 - PRINT OR TYPE Check box if there has been a name change since last filing. Last Name First Name MI Social Security Number Spouse's Last Name First Name MI Social Security Number Due Date for CALENDAR year filers is on or before April 15, 2024 Due Date for FISCAL year filers is the 15th day of the 4th month after the close of the taxable period. If you have a DIN, use the DIN in the taxpayer ID box. DO NOT use FEIN or SSN Taxpayer Identification Number Name of Partnership, Estate, or LLC Number & Street Address Address (continued) Unit Type Unit # City / Town State Zip Code + 4 (or Canadian Postal Code) STEP 2 - Return Type % of NEW HAMPSHIRE Ownership Interest in Entity Type ENTITY TYPE - Check One 1 - INDIVIDUAL 1 - JOINT 3 - PARTNERSHIP/LLC 4 - ESTATE MMDDYYYY Date of Death Established NH Residency INITIAL RETURN FINAL DECEASED MMDDYYYY Social Security Number FINAL RETURN Abandoned NH Residency IRS ADJUSTMENT: A complete federal Revenue Agent Report (RAR) with all applicable Schedules must be included with a complete amended NH AMENDED RETURN tax return. Do not use this form to report IRS adjustments for taxable periods ending on or before December 31, 2020. DP-10 2023 Page 1 of 5 Version 2 07/2024 Print Form Reset Form *00DP102311862* 00DP102311862

1 2 4 New Hampshire Department of Revenue Administration 2023 DP-10 INTEREST AND DIVIDENDS TAX RETURN - continued STEP 3 - Read instructions before you begin INTEREST & DIVIDENDS FROM ALL SOURCES Round to the nearest whole dollar From Your Federal Income Tax Return: (See Instructions) (a) Interest Income. Enter the amount from Line 2(b) of your federal return 1(a) (b) Dividend Income. Enter the amount from Line 3(b) of your federal return 1(b) (c) Federal Tax-Exempt Interest Income. Enter the amount from Line 2(a) of your federal return 1(c) (d) Subtotal Interest and Dividends Income. (Sum of Lines 1(a), 1(b) and 1(c)) Subtotal 1(d) List Taxable Annuities or Actual Cash & Property Distributions From S-Corporations, Trusts/Estates, Partnerships, and LLCs: Entity Codes: 2 = S-CORPORATIONS; 3 = PARTNERSHIPS; 4 = TRUSTS OR ESTATES; 5 = LLC; 6 = FOUNDATIONS; 7 = OTHER I Entity Code II Name of Payor III Payor's ID Number IV Distribution Amount Total from supplemental schedule attached 2 Total Distributions (Sum of Column IV above) 2 3 Subtotal Gross Interest and Dividends Income and Distributions (Line 1(d) plus Line 2) Subtotal 3 List payors and amounts of interest and/or dividends NOT TAXABLE to New Hampshire included on Lines 1(a), 1(b), 1(c) and/or 2: I Reason Code II Name of Payor III Payor's ID Number IV Non-Taxable Amount (a) Subtotal of non-taxable income above (Sum of Column IV) 4(a) (b) Total non-taxable income from supplemental schedule (Attached) 4(b) (c) Non-taxable income (Subtotal of Lines 4(a) plus 4(b)) 4(c) (d) Part-year resident non-taxable income pro rata share 4(d) DP-10 2023 Page 2 of 5 Version 2 07/2024 *00DP102321862* 00DP102321862

New Hampshire Department of Revenue Administration 2023 DP-10 INTEREST AND DIVIDENDS TAX RETURN - continued STEP 3 - (continued) Read instructions before you begin INTEREST & DIVIDENDS FROM ALL SOURCES Round to the nearest whole dollar 4 Total Non-Taxable Income (Sum of Line 4(c) plus Line 4(d)) 4 5 Gross Taxable Income (Line 3 minus Line 4) 5 6 Less: $2,400 for Individual, Partnership and Estate; $4,800 for Joint filers 6 7 Adjusted Taxable Income (Line 5 minus Line 6) If less than zero, use minus sign. 7 Blind Spouse Blind 65 (or over) or disabled Year of Birth Spouse 65 (or over) or disabled Year of Birth 8 Check the exemptions that apply. Total number of boxes checked x $1200 = 8 9 Net Taxable Income (Line 7 minus Line 8). If less than zero, use minus sign. 9 DP-10 2023 Page 3 of 5 Version 2 07/2024 *00DP102331862* 00DP102331862

New Hampshire Department of Revenue Administration 2023 DP-10 INTEREST AND DIVIDENDS TAX RETURN - continued STEP 4 - Calculate Your Tax, Credits, Interest and Penalties Round to the nearest whole dollar 10 New Hampshire Interest and Dividends Tax 10 (Line 9 multiplied by 4%) 11 RSA 77-G Education Tax Credit 11 12 New Hampshire Interest and Dividends Tax Net of Education Tax 12 Credit (Line 10 minus Line 11. If negative enter zero) 13 Payments: (a) Tax paid with application for extension 13(a) (b) Current year estimated tax payments 13(b) (c) Credit carryover from prior tax period 13(c) 13 Subtotal of Lines 13(a) through 13(d) (d) Paid with original return (Amended returns only) 13(d) 14 Subtotal Due (Line 12 minus Line 13 Subtotal) 14 15 Additions to Tax: (a) Interest 15(a) (b) Failure to Pay 15(b) (c) Failure to File 15(c) 15 Subtotal of Lines 15(a) through 15(d) (d) Underpayment of Estimated Tax 15(d) STEP 5 - Calculate Your Net Balance Due or Overpayment 16 (a) Subtotal Due (Line 14 plus Line 15 Subtotal) 16(a) (b) Return Payment Made Electronically 16(b) 17 Net Balance Due (Line 16(a) minus Line 16(b)) 17 PAY THIS AMOUNT (Make Check Payable to State of New Hampshire) 18 OVERPAYMENT (If balance due is less than zero, enter on Line 18) 18 19 Amount of Line 18 to be applied to: (a) Credit - Next Year's Tax Liability (Not available for Federal RAR) 19(a) DO NOT PAY (b) Refund (Only option available for Federal RAR) 19(b) DO NOT PAY DP-10 2023 Page 4 of 5 Version 2 07/2024 *00DP102341862* 00DP102341862

New Hampshire Department of Revenue Administration 2023 DP-10 INTEREST AND DIVIDENDS TAX RETURN - continued Under penalties of perjury, I declare that I have examined this return and to the best of my belief it is true, correct and complete. If prepared by a person other than the taxpayer, this declaration is based on all information of which the preparer has knowledge. POA: By checking this box and signing below, you authorize us to discuss this return with the preparer listed below. TAXPAYER'S SIGNATURE & INFORMATION Signature (in ink) MMDDYYYY If joint return, BOTH parties must sign, even if only one had income MMDDYYYY Print Signatory Name(s) (and Title if applicable) Taxpayer's Phone Number Filing as surviving spouse Form 1310 attached PAID PREPARER'S SIGNATURE & INFORMATION Signature of Preparer MMDDYYYY Printed Name of Preparer Preparer Identification Number Preparer's Phone Number Preparer's Address City / Town State Zip Code + 4 (or Canadian Postal Code) Mail to: NH DRA PO Box 637 Make Check Payable to: STATE OF NEW HAMPSHIRE Enclose but DO NOT staple or tape your FILE ONLINE AT GRANITE TAX CONNECT gtc.revenue.nh.gov/TAP/_/ Concord NH 03302-0637 attachments DP-10 2023 Page 5 of 5 Version 2 07/2024 *00DP102351862* 00DP102351862

2023 DP-10 INTEREST AND DIVIDENDS TAX RETURN GENERAL INSTRUCTIONS DP-10 Instructions 2023 Version 3 07/2024 Page 1 of 8 New Hampshire Department of Revenue Administration WHO AND WHAT IS TAXABLE Taxable income is income received from interest and dividends during the tax year prior to the assessment date by: (a) Individuals who are inhabitants or residents of this state for any part of the taxable year whose gross interest and dividend income from all sources, including income from a qualified investment company pursuant to RSA 77:4, V, exceeds $2,400 during the taxable period. (b) Partnerships, Limited Liability Companies (LLCs), and Associations, the beneficial interest in which is not represented by transferable shares, whose gross interest and dividend income from all sources exceeds $2,400 during the taxable year, but not including a qualified investment company as defined in RSA 77-A:1, XXI, or a trust comprising a part of an employee benefit plan, as defined in the Employee Retirement Income Security Act of 1974, Section 3. (c) Executors deriving their appointment from a court of this state whose gross interest and dividend income from all sources exceeds $2,400 during the taxable year. WHO MUST FILE A RETURN INDIVIDUALS Individuals who are residents or inhabitants of New Hampshire for any part of the tax year must file if they received more than $2,400 of gross interest and/or dividend income for a single individual or $4,800 of such income for a married couple filing a joint New Hampshire return. (Part year residents see below.) JOINT FILERS To ensure your payments are credited to your account, the sequence of names and social security numbers must be consistent on all Interest and Dividends Tax estimates, extensions and returns. PARTNERSHIPS, LLCs, AND ESTATES See separate tables on pages 6 and 7 of these instructions regarding "WHO" and “WHAT” is taxable. NEW HAMPSHIRE RESIDENT/INHABITANT To determine if you are a New Hampshire resident/inhabitant, refer to Rev 902.01, wherein an individual's intent to establish residency by an ongoing physical presence within New Hampshire which is not transitory in nature, shall be evidenced by the following factors: • Maintaining a home or other living quarters in New Hampshire; • Spending a greater percentage of time in New Hampshire than in any other state; • Having family living with them in New Hampshire; • Advising any federal, state, or local agency that the individual considers herself or himself a resident of New Hampshire; • Being employed or conducting business activity within New Hampshire or at a place to which the individual can readily commute from New Hampshire; or • Registering to vote in New Hampshire. Note: - Income received by trusts and foundations treated as grantor trusts under Section 671 of the United States Internal Revenue Code shall be included in the return of their grantor, to the extent that the grantor is an inhabitant or resident of New Hampshire. - Income reported by, and taxed federally as interest or dividends to, a trust or foundation beneficiary shall be included as interest or dividends in the return of such beneficiary, to the extent that the beneficiary is an individual inhabitant or resident of New Hampshire. PART YEAR RESIDENT For New Hampshire Interest and Dividends Tax purposes, a “part year resident” is someone who has permanently established residency in New Hampshire during the year or who has permanently abandoned residency in New Hampshire during the year. A temporary absence for any length of time does not change your state of residency. Part year residents shall be liable for the tax upon that portion of income earned when they were a resident of New Hampshire. The taxable portion of income is determined by multiplying the annual taxable income received by a fraction, the numerator of which shall be the number of days the person was a resident of New Hampshire and the denominator of which shall be 365 days or by providing convincing evidence. Refer to Rev. 903.08 (b)(2) for details. Part year residents are entitled to the full $2,400 exemption (or $4,800 for joint filers) and the full amount for the exemptions shown on Line 8 of the return. Part year residents must file a return if, during the entire year, their gross taxable income was over $2,400 (or over $4,800 for joint filers). Refer to Rev.903.08. WHEN TO FILE Calendar Year: If your return is based on a calendar year, it must be postmarked on or before April 15th. If the 15th falls on a weekend or a recognized State holiday, the return is due on the next business day. Fiscal Year: If your return is based on a taxable period other than a calendar year, it must be postmarked on or before the 15th day of the fourth month following the end of your taxable period. If the 15th falls on a weekend or a recognized State holiday, the return is due on the next business day. When reporting an IRS adjustment, submission must be received within 6 months from the date of final determination. FORMS SHALL NOT BE FILED BY FAX OR EMAIL WHERE TO FILE File on-line using Granite Tax Connect at gtc.revenue.nh.gov/TAP/_/ or mail to NH DRA, PO Box 637, Concord, NH 03302-0637. EXTENSION TO FILE If you have paid 100% of the Interest and Dividends Tax determined to be due by the due date of the tax, you will be granted an automatic 7-month extension to file your New Hampshire Interest & Dividends Tax return. If you meet this requirement, you may file your New Hampshire Interest & Dividends Tax return up to 7 months beyond the original due date of the return and you will not be subject to the late filing penalty. Note: An extension of time to file your return is not an extension of time to pay the tax. If you need to make an additional payment, file a Form DP-59-A Extension along with the payment. File on-line using Granite Tax Connect at gtc.revenue.nh.gov/TAP/_/ or mail to NH DRA, PO Box 1265, Concord, NH 03302-1265. This application and payment must be postmarked on or before the due date of the tax. Failure to pay 100% of the tax due by the original due date will result in the assessment of interest and may result in the assessment of penalties. You are not required to attach a copy of your federal extension to your return. Filing a federal extension does not automatically extend your New Hampshire filing requirements.

2023 DP-10 DP-10 Instructions 2023 Version 3 07/2024 Page 2 of 8 New Hampshire Department of Revenue Administration INDIVIDUALS PARTNERSHIPS, LLCs, ASSOCIATIONS ESTATES IF: Inhabitant or resident of New Hampshire for any part of the taxable period; and Gross interest and dividend income from all sources exceeds $2,400 for individual single filers or $4800 for married individuals filing a joint tax return during the taxable period. IF: Entity has non-transferable shares; Gross interest and dividend income from all sources exceeds $2,400 during the taxable period; Usual place of business in New Hampshire; and Any partner, trustee, member or owner is an inhabitant or resident of New Hampshire. IF: Estate of deceased person who was an inhabitant or resident of New Hampshire for any part of the taxable periods; and Gross interest and dividend income from all sources exceeds $2,400 during the taxable period; WHAT IS TAXABLE - TO THE INDIVIDUAL FILER The actual cash or property distributions you receive from partnerships, LLCs, foundations, associations, estates or trusts fall into one of the following three categories: entirely NOT taxable to New Hampshire, entirely taxable to New Hampshire, or taxable in part to New Hampshire. In general, you can determine which category your income falls into by answering the questions below. For trusts and foundations, see (4) below. • Have you signed and dated the return in blue or black ink? (Rev 2904.04) • Did you enter the same tax identification number used for filing your estimated tax payments? • If this is a joint return, has your spouse included his/her social security number, signed and dated the return in blue or black ink? • If there is a balance due of $1.00 or more, have you enclosed a check for the total amount due? • Did you make the check payable to the State of New Hampshire? • Is the written amount on the check the same as the numeric amount? • Have you signed and dated the check? Post dated checks will not be accepted. • Have you enclosed all pages of the Form DP-10? • Did you mistakenly send a payment in the amount of your credit or refund? WHO IS TAXABLE UNDER RSA 77:3 & REV 900 (a) Is the organization required to file its own New Hampshire Interest and Dividends Tax return? If yes, your entire distribution from the organization is NOT taxable to New Hampshire. See (1) below. Use reason code 6. If no, move on to question B. (b) Does the organization have transferable shares? Can you transfer your shares without causing a dissolution of the organization or without obtaining prior member approval? If yes, your entire ACTUAL distribution from this organization is taxable. See (2) below. If no, move on to (c), below. (c) If the organization is not required to file its own New Hampshire Interest and Dividends Tax return AND the organization has nontransferable shares, then the distribution you received from them is taxable to you as if it had come from its original source. The interest and dividend tax shall be imposed on the portion of the actual distribution which represents interest or dividends received by the entity. See (3) below. Use reason code 7. INTEREST AND DIVIDENDS TAX RETURN GENERAL INSTRUCTIONS (continued) COMMON ERRORS The following is a list of the most common mistakes made by taxpayers when filing a New Hampshire Interest and Dividends Tax return. These, along with other errors, may cause the return or check to be considered an "incomplete return" and may result in the assessment of interest and penalties. To ensure that you have filed a complete return, carefully follow the general and line-by-line instructions and be sure you have done the following: INCOME FROM: PARTNERSHIPS, LLC'S, ASSOCIATIONS, AND ESTATES WHAT IS TAXABLE HOW TO SHOW THE TAXABLE PORTIONS Not applicable. (2) All of your actual and constructive receipt of distribution (including non- cash distributions) from this entity are taxable to New Hampshire regardless of the original source of the income. On page 2, Line 2, enter its entity code, the name of the entity, its federal employer identification number, and the total amount of the distribution you received. (3) A portion of the distribution you received is taxable to you. The taxable portion is determined by multiplying the amount of the actual distribution received by a fraction. The numerator is the total interest and dividends received by the entity. The denominator is the total amount of gross income received by the entity. On page 2, Line 2, enter its entity code, the name of the entity, its federal employer identification number, and the total amount of the distribution you received. Enter the non-taxable amount on Line 4 and use Reason Code 7. (1) No part of your distribution is taxable to New Hampshire.

2023 DP-10 DP-10 Instructions 2023 Version 3 07/2024 Page 3 of 8 New Hampshire Department of Revenue Administration Of the interest and dividends received, which would be taxable if received by a resident individual an amount proportionate to the aggregate interest of the partners or members who are inhabitants of this state. List the interest and dividend income on Lines 1(a), (b) and (c) and Line 2. Enter the non-taxable amounts on Line 4, with the reason code and the payor's name and federal employer identification number. Use reason code 8 to reflect non- taxable interest and dividends allocated to non-New Hampshire residents interest holder. WHAT IS TAXABLE - TO THE PARTNERSHIP, LLC OR ASSOCIATIONS INCOME FROM: "S" CORPORATIONS All actual and constructive receipt of distributions (including non-cash distributions) from an “S” corporation are taxable to New Hampshire regardless of the original source of the income. WHAT IS TAXABLE HOW TO SHOW THE TAXABLE PORTIONS INCOME FROM: TRUSTS & FOUNDATIONS NOT TREATED AS GRANTOR TRUSTS A portion of the distribution you received may be taxable to you. The taxable portion is determined by multiplying the income distribution received by a fraction. The numerator of which shall be the total interest and dividend income taxed federally as interest and dividends to a trust or foundation beneficiary. The denominator of which shall be the total of the beneficiary's share of income net of apportioned deductions. On page 2, Line 2, enter its entity code, the name of the entity, its federal employer identification number, and the total amount of the distribution you received. Enter the non-taxable amount on Line 4 and use Reason Code 7 for trusts and code 12 for foundations. WHAT IS TAXABLE HOW TO SHOW THE TAXABLE PORTIONS On page 2, Line 2, enter entity code 2, the name of the "S" corporation, its federal employer identification number, and the total amount of the distribution you received. INCOME FROM: PARTNERSHIPS, LLC'S, OR ASSOCIATIONS (when ALL of the interest holders are residents or inhabitants of New Hampshire) All interest and dividends received which would be taxable if received by a resident individual. WHAT IS TAXABLE HOW TO SHOW THE TAXABLE PORTIONS List the interest and dividend income on Lines 1(a), (b) and (c) and Line 2. Enter the non-taxable amounts on Line 4, with the reason code and the payor's name and federal employer identification number. INCOME FROM: PARTNERSHIPS, LLC'S, OR ASSOCIATIONS (when SOME of the interest holders are residents or inhabitants of New Hampshire) WHAT IS TAXABLE HOW TO SHOW THE TAXABLE PORTIONS CONFIDENTIAL INFORMATION Tax information disclosed to the New Hampshire Department of Revenue Administration is held in strict confidence by law. The information may be disclosed to the United States Internal Revenue Service, agencies responsible for the administration of taxes in other states in accordance with compacts for the exchange of information, and as otherwise authorized by RSA 21-J:14. TAXPAYER IDENTIFICATION The Commissioner of the Department of Revenue is authorized pursuant to RSA 21-J:27-a to require submission of an SSN, FEIN, or any other identifying number used in filing or preparing federal tax documents. If you do not have any such identifying number, or share one with another taxpayer, then, under Rev 2903.01, you must obtain a Department Identification Number (DIN). If you have a DIN, use it on all New Hampshire filings. To ensure that your filings and payments are applied to the correct account, the sequence of names and taxpayer ID numbers on all filings must be consistent. The failure to provide a taxpayer identification number may result in the rejection of filed documents. Failure to timely file documents complete with a consistent taxpayer identification number may result in the imposition of penalties and interest, the dis-allowance of claimed exemptions, exclusions, credits, deductions, or an adjustment that may result in increased tax liability. INTEREST AND DIVIDENDS TAX RETURN GENERAL INSTRUCTIONS (continued)

2023 DP-10 DP-10 Instructions 2023 Version 3 07/2024 Page 4 of 8 New Hampshire Department of Revenue Administration AMENDED RETURNS If, after your return is filed, you discover an error was made, promptly file an amended New Hampshire return by completing a corrected Form DP-10 and checking the "AMENDED RETURN” box in Step 2. New Hampshire does not have a separate form for amended returns. Do not use Form DP-10 to report an adjustment made by the Internal Revenue Service as the result of an audit for taxable periods ending on or before December 31, 2020. See "IRS Adjustment" below for additional information. Do not include a copy of the originally submitted return. ROUNDING OFF The amounts on all Interest and Dividends Tax forms shall be rounded to the nearest whole dollar. IRS ADJUSTMENT To report a change to your Interest and Dividends Tax Return resulting from a federal audit, file a complete amended NH Form DP-10 and include a complete federal Revenue Agent Report (RAR) with all applicable Schedules. To report a change for taxable periods ending on or before December 31, 2020, you must file a separate Form DP-87 ID, for each year. Follow the line-by-line instructions when filling out the Form DP-87 ID. The completed DP-87 ID must be signed in ink and include the IRS examination form reporting the change. An incomplete Report of Change Form DP-87 ID will not be accepted. NEED FORMS? To obtain additional forms, you may visit our website at www.revenue.nh.gov or call the Forms Line at (603) 230-5001. NEED HELP? Call the Department of Revenue Administration, Taxpayer Services at (603) 230-5920. Individuals with hearing or speech impairments may call TDD Access: Relay NH 1-800-735-2964. INTEREST AND DIVIDENDS TAX RETURN GENERAL INSTRUCTIONS (continued)

2023 DP-10 Page 5 of 8 New Hampshire Department of Revenue Administration INTEREST AND DIVIDENDS TAX RETURN LINE-BY-LINE INSTRUCTIONS STEP 1 At the top of the return enter the beginning and ending dates of the taxable period. Enter the taxpayer's name, address, and tax identification number, whether it be a SSN, FEIN, or DIN in the spaces provided. If filing a joint return enter your spouse's name and SSN in the spaces provided. SSNs are required pursuant to the authority granted by Title 42 U.S.C. 405. Wherever SSNs or FEINs are required, taxpayers who have been issued a DIN must use their DIN only, not their SSN or FEIN. If filing as a Partnership, Estate, or LLC, do not provide your name and personal social security number or the name and social security number of your spouse. STEP 2 Check one box to indicate entity type and enter the percentage of NH ownership interest. If you established residency on or after January 1st of this tax period, check the “Initial Return” box and enter the date of residency. If you abandoned residency during the year, check the “Final Return” box and enter the date. Check the appropriate box that applies and enter the date of the event. If "Final Deceased", enter the date of death and the SSN of the deceased. If the taxpayer or spouse is deceased and the Interest and Dividends Tax return results in an overpayment to be refunded, Form NH-1310, “Statement of Claimant to Refund Due a Deceased Taxpayer,” is required to issue the refund to someone other than the deceased party. Form NH-1310 is available on our website at www.revenue.nh.gov or by calling the Forms Line at (603) 230-5001. File Form NH-1310 with the return if applicable. If this is an amended return, check the "Amended Return" box. Check the "IRS Adjustment" box to report a change to your Interest and Dividends Tax return as a result of an IRS audit adjustment for taxable periods ending after December 31, 2020. To report IRS audit changes for taxable periods ending on or before December 31, 2020, you must file a NH Form DP-87 ID for the appropriate year. See Form DP-87 Report of Change (ROC) General Instructions. STEP 3 LINE 1(a) INTEREST INCOME Enter on Line 1(a) ALL interest income. For individual and joint filers, the amount to be reported on Line 1(a) is from Line 2(b) of IRS Form 1040. For all other filers, the amount to be reported on Line 1(a) is the total of all interest income reported on your federal return. If you are not required to file a federal return, enter your interest as reported on your Forms 1099 and elsewhere. NOTE: All interest income which is not taxable to New Hampshire will be deducted on Line 4, however it must be included in line 1(a) first. LINE 1(b) DIVIDEND INCOME Enter on Line 1(b) ALL ordinary dividend income. For individual and joint filers, the amount to be reported on Line 1(b) is from Line 3(b) of IRS Form 1040. If you are not required to file a federal return, enter your dividend income as reported on your Form(s) 1099 and elsewhere. NOTE: All dividend income which is not taxable to New Hampshire will be deducted on Line 4, however it must be included on line 1(b) first. LINE 1(c) FEDERAL TAX-EXEMPT INTEREST INCOME Enter on Line 1(c) the amount of ALL federal tax-exempt interest income. For individuals and joint filers, the amount to be reported on Line 1(c) is from IRS Form 1040, Line 2(a). Unless specifically exempt by New Hampshire law, all federal tax-exempt interest income is taxable to New Hampshire. NOTE: All federal tax-exempt interest income that is not taxable to New Hampshire will be deducted on Line 4, however it must be included on line 1(c) first. LINE 1(d) SUBTOTAL INTEREST AND DIVIDEND INCOME Enter the sum of Lines 1(a), 1(b), and 1(c). LINE 2 TAXABLE ANNUITIES OR ACTUAL CASH AND PROPERTY DISTRIBUTIONS In Column I, enter the entity code number that represents the entity type of the payor. See the box below for ENTITY TYPE CODES. In Column II, enter the name of the payor. In Column III, enter payor's SSN or FEIN. In Column IV, enter the total amount of cash or property distribution received or constructively received. This amount may not correspond to any line on your Federal Form 1040 or Federal Schedule K-1. NOTE: This is not a tax on pass-through portfolio income, gains or losses from a Federal Schedule K-1. Therefore, do not include any pass-through income, gains or losses from Federal Schedule K-1. Enter any taxable annuities or the actual cash or property distributions you received or constructively received from any of the taxable income classes described in RSA 77:4. These distributions are subject to tax in New Hampshire as a "dividend". Taxable annuities are those annuities not invested in a tax-deferred investment plan pursuant to RSA 77:4-b. ALL NONTAXABLE INCOME WILL BE DEDUCTED ON LINE 4. Foundations 6 LLCs 5 4 Trusts or Estates Partnerships 3 S-Corporations 2 Entity Type Entity Code Other 7 The entity type "foundations" refers to "civil law foundations" created pursuant to RSA 564-F LINE 3 SUBTOTAL GROSS INTEREST AND DIVIDENDS INCOME AND DISTRIBUTIONS Enter the sum of Line 1(d) plus Line 2. DP-10 Instructions 2023 Version 3 07/2024

2023 DP-10 Page 6 of 8 New Hampshire Department of Revenue Administration STEP 3 (continued) LINE 4 INTEREST AND/OR DIVIDENDS INCOME NOT TAXABLE TO NEW HAMPSHIRE In Column I, enter the reason code number which corresponds to the reason the income is not subject to the Interest and Dividends Tax. (See the box below for reason codes). In Column II, enter the name of the payor. In Column III, enter the payor's social SSN or FEIN, if known. In Column IV enter the non-taxable amount. These items should only be deducted if they were included on Lines 1(a), 1(b), 1(c), and/or 2. INTEREST AND DIVIDENDS TAX RETURN LINE-BY-LINE INSTRUCTIONS (continued) Return of capital 11 Distributive share of the entity's interest or dividend income indicated on Schedule K-1 and included in the partner, beneficiary or shareholders federal income tax return 10 Specifically exempted Puerto Rico, Guam, and Virgin Island bonds 9 Allocation to non-New Hampshire residents or portion of estate distributed to non-taxable persons or organizations 8 A portion of interest or dividend income from a partnership/fiduciary with non-transferable shares which is not subject to I&D tax 7 100% of K-1 interest or dividend income from partnership/fiduciary with non-transferable shares which is subject to I&D tax 6 Liquidating distributions 5 Individual retirement account/Keogh plans/other exempt retirement plans 4 Long or short term capital gains included in Line 3 3 New Hampshire municipal bond 2 Direct US government obligations 1 REASON REASON CODE Non-taxable portion of distribution from a "civil law foundation" pursuant to RSA 564-E 12 LINE 4(a) SUBTOTAL OF NON-TAXABLE INCOME Enter the sum of column IV. LINE 4(b) TOTAL NON-TAXABLE INCOME FROM SUPPLEMENTAL SCHEDULE If additional space is necessary to report non-taxable income, include a supplemental schedule with the return and enter the total non-taxable income from that schedule on line 4(b). LINE 4(c) NON-TAXABLE INCOME Enter the sum of Line 4(a) plus Line 4(b). LINE 4(d) PART-YEAR RESIDENT NON-TAXABLE INCOME PRO RATA SHARE A part-year resident is a resident who established or abandoned residency during the tax year. Part-year residents may prorate interest and dividends income. Individuals filing as part-year residents may deduct the amount of taxable income earned while not a resident of New Hampshire. To determine the annual taxable income for the pro rata share calculation, subtract Line 4(c) from the subtotal of gross income on Line 3, then apply the following calculation to that figure to determine the amount to enter on Line 4(d), part-year resident pro rata share or determined by applying the methodology described in Rev 903.08(b)(2). Annual taxable income x Number of days a Non-New Hampshire Resident 365 days of the year Enter the total of Line 4(c) plus Line 4(d) on Line 4. LINE 5 GROSS TAXABLE INCOME Enter the amount of Line 3 minus Line 4. LINE 6 Enter the applicable income exemption ($2,400 for individual, partnership, LLC or estate, or $4,800 for joint filers). LINE 7 ADJUSTED TAXABLE INCOME Line 5 minus Line 6 (If less than zero, report as a negative amount). LINE 8 Check any exemptions that apply. Enter the total number of boxes checked. Multiply the number of boxes checked by $1,200 and enter the result. DP-10 Instructions 2023 Version 3 07/2024

2023 DP-10 DP-10 Instructions 2023 Version 3 07/2024 Page 7 of 8 New Hampshire Department of Revenue Administration INTEREST AND DIVIDENDS TAX RETURN LINE-BY-LINE INSTRUCTIONS (continued) x . = Interest due Enter on Line 15(a) (see below for applicable rates) NOTE: The interest rate is recomputed each year under the provisions of RSA 21-J:28, II. Applicable rates are as follows: STEP 3 (continued) LINE 9 NET TAXABLE INCOME Line 7 minus Line 8 (If less than zero report as a negative amount). STEP 4 LINE 10 Enter New Hampshire Interest and Dividends Tax before Education Tax Credit. If Line 9 is a positive number, calculate your Interest and Dividends Tax by multiplying Line 9 by 4% (.04). If Line 9 is a negative number, enter zero on Line 10. LINE 11 Enter total Education Tax Credits available (RSA 77-G). LINE 12 Calculate Interest and Dividends Tax net of Education Tax Credit (Line 10 minus Line 11). If a negative amount enter zero. LINE 13 Enter your payments on Lines 13(a) through 13(d). Enter the sum of your payments on Line 13. LINE 14 Calculate the balance of the tax due (Line 12 minus Line 13). Enter the remainder or balance of tax due on line 14. LINE 15 Calculate your interest and penalties, if any, as follows, and enter the amounts on Lines 15(a) through 15(d). Enter sum of interest and penalties on Line 15. (a) INTEREST Interest is calculated on the balance of tax due from the original due date to the date paid at the applicable rate listed below. Tax due multiplied by the number of days from due date to date tax was paid, then multiplied by daily rate decimal equivalent. Tax Due # of Days Daily Decimal Rate Equivalent PERIOD RATE DAILY RATE DECIMAL EQUIVALENT 1/1/2024 - 12/31/2024 9% .000247 1/1/2021 - 12/31/2022 5% .000137 1/1/2019 - 12/31/2020 7% .000192 1/1/2017 - 12/31/2018 6% .000164 1/1/2013 - 12/31/2016 5% .000137 1/1/2010 - 12/31/2012 6% .000164 1/1/2023 - 12/31/2023 7% .000192 (b) FAILURE TO PAY A penalty equal to 10% of any nonpayment or underpayment of taxes shall be imposed if the taxpayer fails to pay the tax when due. If the failure to pay is due to fraud, the penalty shall be 50% of the amount of the nonpayment or underpayment. (c) FAILURE TO FILE A taxpayer failing to timely file a complete return may be subject to a penalty equal to 5% of the tax due or $10, whichever is greater, for each month or part thereof that the return remains unfiled or incomplete. The total amount of this penalty shall not exceed 25% of the balance of tax due or $50, whichever is greater. Calculate this penalty starting from the original due date of the return until the date a complete return is filed. (d) UNDERPAYMENT OF ESTIMATED TAX PENALTY If you estimate your current year tax to be greater than $500, then you are required to make estimated tax payments during the tax year. To calculate your penalty for nonpayment or underpayment of estimated tax or to determine if you qualify for an exception from making estimated tax payments, complete and attach Form DP-2210/2220. Form DP-2210/2220 may be obtained from our website at www.revenue.nh.gov or by calling the Forms Line at (603) 230-5001.

2023 DP-10 DP-10 Instructions 2023 Version 3 07/2024 Page 8 of 8 New Hampshire Department of Revenue Administration INTEREST AND DIVIDENDS TAX RETURN LINE-BY-LINE INSTRUCTIONS (continued) STEP 5 LINE 16(a) Enter the subtotal of amount due. (Line 14 plus Line 15). LINE 16(b) Enter the amount of any return payment being made electronically. LINE 17 Calculate your net balance due. Line 16(a) minus Line 16(b). Enter the result on Line 17. If result is less than zero, enter zero and go to Line 18. If the net balance due is less than $1.00, do not pay but still file the return. LINE 18 If the total payments (Line 13 plus Line 16(b)) are greater than total tax (Line 10 plus Line 15), then you have overpaid. Enter the overpayment amount on Line 18. LINE 19 The taxpayer has an option of applying any part of or the total amount of the overpayment as a credit to next year’s tax liability. Enter the desired credit on Line 19(a). The remainder, which will be refunded, should be entered on Line 19(b). If Line 19(a) is not completed, the entire overpayment will be refunded. POA By checking the POA box and signing the return, the taxpayer authorizes the Department to discuss this return with the paid preparer listed below. This is a limited POA. Preparers shall be required to submit a Form DP-2848 for other tax matters and/or years. SIGNATURE(S) You MUST SIGN IN BLUE OR BLACK INK AND DATE the return. JOINT FILERS If you are filing a joint return, both spouses must sign in blue or black ink and date the return even if only one of you had income. SURVIVING SPOUSE If your spouse died during the taxable period but prior to the filing of this return, enter the appropriate information in Step 2, sign the return as a joint filer, and check the box below the signature line to indicate you are filing as surviving spouse. If your spouse died during the taxable period and the tax return indicated a refund is due, file Form NH-1310 to authorize the Department to issue the refund to someone other than the deceased person. Form NH-1310 is available on our website at www.revenue.nh.gov or by calling the Forms Line at (603) 230-5001. File Form NH-1310 by attaching it to the return. ESTATE If you are signing on behalf of an estate, you must indicate under what authority you are signing. (i.e. "executor", or "administrator") and include a copy of the Certificate of Appointment. PREPARER If you paid a preparer to complete this return, then the preparer must also sign in ink and date the return. The preparer must also provide his/her federal preparer tax identification number (PTIN) and complete address.