New Hampshire                     202  
                    Department of                                             *SCHD032311862*
                                             Schedule III
              Revenue Administration                                          SCHD032311862

                               NET FOREIGN DIVIDEND FACTOR INCREMENTS - SCHEDULE III

Principal Business Organization Name 

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

                    Column A                                         B        C                      D
                                                                                             PERCENTAGE 
                    NAME OF PAYOR                          DIVIDEND           TAXABLE INCOME
                                                                                             (B ÷ C)

1

2

3

4

5

6

7

8
                                             TOTAL 

 Column E                            F                               G        H                      I
                                                                                             AVERAGE PROPERTY 
 SALES AND RECEIPTS                  PAYROLL          BEGINNING PROPERTY      ENDING PROPERTY
                                                                                             (G + H) ÷ 2

1

2

3

4

5

6

7

8

 Schedule III 202  
 Version    08/202                                                                                   Page 1 of 2

                    New Hampshire                     202                     *SCHD032321862*
                    Department of
                                              Schedule III                                   SCHD032321862
               Revenue Administration

                    NET FOREIGN DIVIDEND FACTOR INCREMENTS - SCHEDULE III   $0/5*/6&% 

Principal Business Organization Name 

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

  Column J                           K                               L        M                                  N
                                     TOTAL PROPERTY        MODIFIED SALES     MODIFIED PAYROLL           MODIFIED PROPERTY 
  RENTS x 8
                                     (I  + J)                   (D x E)       (D x F)                     (D x K)

1

2

3

4

5

6

7

8

                                              TOTAL

  TOTALS   Carry total modified factor amounts to Form Schedule II, Lines 1(b), 4(b) and 5(b) 

  Schedule III 202                                                                                               Page 2 of 2
  Version 1  08/202