New Hampshire                                       202  
                          Department of                                                    *0010412311862*
                      Revenue Administration                          NH-1041                                                  0010412311862

                                                            BUSINESS PROFITS TAX RETURN
Business Organization Name 

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

 1      GROSS BUSINESS PROFITS                                                                                                            Round to the nearest whole dollar

         1(a)   Interest income reported on Federal Form 1041, Line 1                                                          1(a)

         1(b)   Total Dividends reported on Federal Form 1041, Line 2(a)                                                       1(b)

         1(c)   Business income or (loss) reported on Federal Form 1041, Line 3                                                1(c)

         1(d)   Net Capital gain only reported on Federal Form 1041, Line 4                                                    1(d)

         1(e)   Rents, and royalties reported on Federal Form 1041, Line 5                                                     1(e)

         1(f)    Farm Income or (loss) reported on Federal Form 1041, Line 6                                                   1(f)

         1(g)   Ordinary gain or (loss) reported on Federal Form 1041, Line 7                                                  1(g)

         1(h)   Other income reported on Federal Form 1041, Line 8                                                             1(h)

         1(i)    Other business expenses not reported above (attach schedule)                                                  1(i)
         1(j)    Business profits from business activity of an association or trust (Combine Lines 1(a) through 1(h)  
         and from the result subtract Line 1(i))                                                                      1(j)

2      INCREASE or DECREASE TO GROSS BUSINESS PROFITS TO RECONCILE WITH IRC 

         2(a)   Add amount of IRC §179 expense taken on federal return in excess of the amount permitted pursuant 
         to RSA 77-A:3-b, IV, including carryover amounts deducted in this taxable period                                            2(a) 
         2(b)   Add the amount of bonus depreciation taken on the federal return for assets placed in service this period 
         pursuant to RSA 77-A:3-b, I                                                                                           2(b) 
         2(c)   Add any other deductions or exclusions taken on the federal return that need to be eliminated or  
         adjusted pursuant to RSA 77-A:1, XX and 77-A:3-b, III.  Complete and attach Schedule IV                                   2(c)
         2(d)   Deduct regular depreciation related to IRC §179 and bonus depreciation not allowed for this taxable 
         period or for prior taxable periods                                                                                   2(d)
         2(e)   Deduct any other items included on the federal return that need to be eliminated or adjusted pursuant to 
         RSA 77-A:1, XX or RSA 77-A:4, XIX.  Complete and attach Schedule IV                                                   2(e)
         2(f)   Increase or Decrease the net gain or loss on the sale of assets used in the business that have a different  
         state basis from the tax basis reported on the federal return                                                         2(f)
         2(g)   Net Lines 2(a) through 2(f)                                                                                    2(g)

3       Subtotal Line 1(j) adjusted by Line 2(g)                                                                               3

4       Separate entity items of income or expense (attach schedule)                                                          4

5       Gross Business Profits (combine Line 3 and Line 4)                                                                    5

         NH-1041 202                                                                                                                        Page 1 of 3
         Version 1 08/202 

                            New Hampshire                                 202                             *0010412321862*
                                   Department of
                        Revenue Administration                            NH-1041                                                0010412321862

                                                                BUSINESS PROFITS TAX RETURN 

Business Organization Name 

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

NH-1041 continued
6        ADDITIONS AND DEDUCTIONS (RSA 77-A:4)                                                                                                    Round to the nearest whole dollar

          6(a)   Deduct interest and dividends subject to tax under RSA 77 (RSA 77-A:4, I)  (no longer applies to trusts)                    6(a)

          6(b)   Deduct interest on direct US Obligations (RSA 77-A:4, II)                                                               6(b)
          6(c)   Add income taxes or franchise taxes measured by income (attach schedule of taxes by state)   
                 (RSA 77-A:4, VII)                                                                                               6(c)
          6(d)   Deduct wage adjustment required by IRC §280C (RSA 77-A:4, IX)                                                   6(d)

          6(e)   Add expenses related to federal constitutionally exempt income (RSA 77-A:4, X)                                            6(e)

          6(f)    Deduct research contribution (attach computation) (RSA 77-A:4, XII)                                            6(f)
          6(g)    Adjustments to gross business profits required due to the increase in the basis of assets resulting from the sale or
                 exchange of an interest in the business organization (RSA 77-A:4, XIV)
            Add the amount of the increase in the basis of assets federally, due to  
            the sale or exchange of an interest in the business organization                                                     6(g) - A

 Check yes if an election is being made to recognize the basis increase for any sale or exchange reported above                      Yes        Multiple Transactions Yes
                                                                                                                                                  (schedule attached)
             If not making an election, deduct the basis increase associated with the 
             sale or exchange(s). If making an election, enter zero.  If reporting multiple 
             transactions, please attach a schedule reporting the details for each 
             transaction.                                                                                                        6(g) - B
            Add the amount of depreciation/amortization on the federal return attributable to an      
                 increase in the basis of assets not recognized for NH purposes                                                  6(g) - C
            Upon the sale of assets, adjust the net gain or loss attributable to an  
            increase in the basis of assets that was not recognized for NH purposes                                              6(g) - D

             Net Lines 6(g) - A through 6(g) - D                                                                                           6(g) 

          6(h)     Add Qualified Investment Company (QIC) holders' proportional share of QIC profits (RSA 77-A:4, XV)               6(h)

          6(i)     Deduct assistance payments under 12 USC § 1823 (RSA 77-A:4, XVI)                                              6(i)

          6(j)    Net Lines 6(a) through 6(i)                                                                       6(j)

7       Adjusted Gross Business Profits (Sum of Lines 5 and 6(j))                                                      7
8       New Hampshire Apportionment (If other than 100%, complete Form DP-80 BPT Apportionment Schedule. 
         Enter percentage from Form DP-80, Line 1(c))                                                                                           8
                                                                                    Exempt  under    P.L. 86-272                                  

9     New Hampshire Business Profits before NOL (Line 7 multiplied by  Line 8. If negative, enter zero.)                          9

           NH-1041 202                                                                                                                            Page 2 of 3
           Version 1 08/202 

                        New Hampshire                           202                            *0010412331862*
                            Department of
                    Revenue Administration                   NH-1041                                             0010412331862

                                                          BUSINESS PROFITS TAX RETURN 
Business Organization Name 

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

NH-1041 continued

10      Deduct New Hampshire Net Operating Loss Deduction (NOLD) (attach Form DP-132) (RSA-77-A:4, XIII) 

       NOLD available                                                                                            10 - A

          Less NOLD used this tax period                                                                         10

          NOLD to be carried forward                                                                             10 - B

11     New Hampshire Taxable Business Profits (Line 9 minus Line 10. If negative, enter zero.)                    11

12     Compute tax (Line 11 multiplied by 7. %)                                                                  12

13     (a) BET Credit only - attach BET Credit Worksheet                                                 13(a)
       -OR-
                                                                                                                       13(b)
       (b) Other credits including BET  (attach Form DP-160) 
14    New Hampshire Business Profits Tax Net of Statutory Credits (Line 12 minus Line 13(a) or 13(b),   
      DV DSSOLFDEOH  Fannot be less than zero) Report on BT-Summary, Line 1(b)                                 14

       This return must be accompanied by complete and legible copies of the appropriate federal forms and schedules. 

       NH-1041 202                                                                                                                Page 3 of 3
       Version 1 08/202