New Hampshire                              202  
                             Department of                                                        *DP22102311862*
                                                                  DP-2210/2220
                          Revenue Administration                                                           DP22102311862

                             EXCEPTIONS AND PENALTY FOR THE UNDERPAYMENT OF ESTIMATED TAX
Taxpayer Name

Taxpayer Identification Number                                                           MMDDYYYY                          MMDDYYYY
                                                     For the CALENDAR year 202  or 
                                                         other taxable period beginning:                   and ending:

Check One:                   Business Tax Return(s)             Interest & Dividends Tax Return       Other

PART I - CALCULATE YOUR UNDERPAYMENT                                                                                       Round to the nearest whole dollar
1  Current year tax                                                                                                       $

2   90% of Line 1 (Line 1 x .90)                                                                                          $

3(a)  Enter in Columns A through D the installment dates                   A                      B        C                       D
          that correspond to the 15th of the 4th, 6th, 9th, and 
          12th months of your tax period or specify statutory  
          due dates. (I&D filers see instructions)
3(b)   Applicable percentages                                              25%                    25%      25%                     25%
3(c)   Enter Line 2 multiplied by Line 3(b) for Columns A  
          through D
4       Amount paid timely or credited for each period

5       Overpayment of previous installment calculated on Line 7 

6       Total (Line 4 plus Line 5)
7       Overpayment (Line 6 minus Line 3(c)). Enter in Line 5 of  
          next column
8       Underpayment (Line 3(c) minus Line 6)

PART II - EXCEPTIONS TO PENALTY   - See Instructions

9       Cumulative amount paid or credited from the beginning              A                      B        C                       D
          of the tax year through the installment dates  
          (see instructions)
10     Applicable percentages                                              25%                    50%      75%                     100%
11     Exception, prior period’s tax (prior year must be  
          12 full months) (RSA 21-J:32, IV(a))
12     Applicable percentages                                              25%                    50%      75%                     100%
13     Exception, prior period’s tax base and facts using 
          current years tax rate (RSA 21-J:32, IV(b))
14     Applicable percentages                                             22.5%                   45%      67.5%                   90%
15     Exception, tax on annualized income  
          (RSA 21-J:32, IV(c)) (Attach schedule)

          DP-2210/2220  202                                                                                                Page 1 of 2
          Version 1 0 /202 

                       New Hampshire                                       202  
                                Department of                                                  *DP22102321862*
                                                                  DP-2210/2220
                      Revenue Administration                                                     DP22102321862

              EXCEPTIONS AND PENALTY FOR THE UNDERPAYMENT OF ESTIMATED TAX - Continued
Taxpayer Name

Taxpayer Identification Number                                                   MMDDYYYY                   MMDDYYYY
                                                 For the CALENDAR year 202  or 
                                                 other taxable period beginning:                 and ending:

PART III - CALCULATE THE PENALTY

                                                                            A                  B C                   D

16    Amount of underpayment from Part I, Line 8
17    Enter the date of payment or statutory due date of tax,     
         whichever is earlier
18   Enter the number of days from installment date (Line 3(a)) 
        to date shown on Line 17
19   Interest due through   Number of Days  x  %    Y      Underpayment 
12/31/2  at  %:                                           amount (Line 16) 
(see instructions)
20   Interest due after         Number of DaZT     Yx  %  Underpayment
12/31/2  at  %:                    365                    amount (Line 16) 
(see instructions)
21   Penalty for Underpayment of Estimated Tax (Line 19 plus Line 20)

22   Total Penalty for Underpayment of Estimated Tax (Total of Columns A through D, Line 21).  

Note:  For interest rate in other years see instructions

      DP-2210/2220  202                                                                                       Page 2 of 2
      Version 1 0 /202