DO NOT ATTACH TO RETURN                                                                     Print Form       Reset Form

                    New Hampshire  
                        Department of                           AU-208                  *0AU2082211862*
                Revenue Administration
                                                                                                     0AU2082311862
                            QUALIFIED INVESTMENT COMPANY (QIC) REPORT
STEP 1 - PRINT OR TYPE                        MMDDYYYY                                  MMDDYYYY

            For the taxable period beginning:       0 1 0   1 2 0 2 3 and ending:       1 2       3 1 2      0 2 3
Name of Business Entity                                                                           Taxpayer Identification Number
BEACHES CANOPY LLC                                                                                4 5   6    4 5 6 4 5          1
Number & Street Address                                                                           City / Town
12541 NEGRIL HWY                                                                                  HOOKSETT
Address (continued)                                                                               State        Zip Code + 4 (or Canadian Postal Code)
                                                                                                  NH           0 3 1 0 6 -          1 2 3 4
STEP 2

Aggregate Amount of Funds Invested as of Period End                   $                                          6 5 0          0 0
QIC Interest Holders (If more than 5 QIC Interest Holders attach a supplmental schedule)
Individual or Business Name                                                                       Taxpayer Identification Number
SARA SMITH                                                                                          4 5 6 4 6 4 6 5               1
Number & Street Address                                                                           Proportional Share of Income
45 SCHOOL ST UNIT 7                                                                                                  1 5          0 0 0
City / Town                                           State Zip Code + 4 (or Canadian Postal Code)
CONCORD                                               NH    0 3 3 0 1
Individual or Business Name                                                                       Taxpayer Identification Number
EVAN AKERS                                                                                          4 7 8 7 8 7 8 7 8
Number & Street Address                                                                           Proportional Share of Income
12 BASKETBALL RD                                                                                                     2 0          0 0 0
City / Town                                           State Zip Code + 4 (or Canadian Postal Code)
SALEM                                                 NH    0 3 0 7 9 - 1 2             1 2
Individual or Business Name                                                                       Taxpayer Identification Number
WALTER WALKER                                                                                       5 6 5 6 5 6 5 6 5
Number & Street Address                                                                           Proportional Share of Income
32 RED ROSE LN                                                                                                       3 0          0 0 0
City / Town                                           State Zip Code + 4 (or Canadian Postal Code)
CONCORD                                               NH    0 3 3 0 2
Individual or Business Name                                                                       Taxpayer Identification Number

Number & Street Address                                                                           Proportional Share of Income

City / Town                                           State Zip Code + 4 (or Canadian Postal Code)
                                                       
Individual or Business Name                                                                       Taxpayer Identification Number

Number & Street Address                                                                           Proportional Share of Income

City / Town                                           State Zip Code + 4 (or Canadian Postal Code)
                                                       
AU-208   202  3                                                                                                                   Page 1 of 4
Version 1 8  0 /2023

                       New Hampshire  
                        Department of                                  AU-208     *0AU2082221862*
                 Revenue Administration
                                                                                                           0AU2082321862
STEP 3
QIC Manager Name                                                                                        Taxpayer Identification Number
SARA SMITH                                                                                              4 5 6 4 6 4 6 5               1
Number & Street Address                                                                                 City / Town
45 SCHOOL ST                                                                                            CONCORD
Address (continued)                                                                                     State      Zip Code + 4 (or Canadian Postal Code)
UNIT 7                                                                                                  NH         0 3 3 0 1

STEP 4

Income Received in the Taxable Period (attach supporting schedule)              $                                  7 5                0 0 0        0 0

Expenses Incurred in the Taxable Period (attach supporting schedule)            $                                                     6 5 0        5 5

STEP 5

Check this box if a copy of the Federal Tax Return is attached in lieu of completing Steps 2 through 4 above.
                                                     MMDDYYYY
Date the Federal Tax Return was filed with the IRS.  1 0 2           2   2 0 2 3

STEP 6 
Signature (in ink) of Duly Authorized Representative                       Print Signatory Name & Title              MMDDYYYY
                                                                           SARA SMITH MANAGER                        1     1 3          0 2        0 2   3

Signature (in ink) of Paid Preparer Other Than Authorized Representative   Preparer's Tax ID Number     MMDDYYYY

Print Preparer's Name 

Number & Street Address                                                                                 City / Town
45 SCHOOL ST                                                                                            CONCORD
Address (continued)                                                                                     State      Zip Code + 4 (or Canadian Postal Code)
UNIT 7                                                                                                  NH         0 3 3 0            1

                                                     Mail To: NH DRA 
                                                     PO Box 637 
                                                     Concord NH 03302-0637

AU-208   202  3                                                                                                                         Page 2 of 4
Version 1   8   0 /2023

                         New Hampshire  
                         Department of                         AU-208
                    Revenue Administration
WHO MUST FILE 
A business entity that elects qualified investment company (QIC) status for the stated tax period (and all succeeding tax periods until the election is terminated) 
is required to annually file this report with the Department. 
WHAT TO FILE 
This report completed through Step 6, OR, the report completed only as to Step 1, Step 5 and Step 6 accompanied by a copy of the QIC federal income tax 
return filed with the Internal Revenue Service for the tax period, shall be filed with the Department. 
WHEN TO FILE 
The report, along with a copy of the QIC federal income tax return, if such filing method is chosen, must be filed with the Department on or before 30 days 
following the filing of the QIC's federal income tax return with the Internal Revenue Service for the tax period. 
WHERE TO FILE 
The report and accompanying documents, if applicable, shall be mailed to the NH Dept of Revenue Administration, Taxpayer Services, PO Box 637, Concord, 
NH 03302-0637. 
PENALTIES FAILURE TO TIMELY FILE REPORT 
Any QIC which fails to timely file the report as required by RSA 77-A:5-b, II shall pay a penalty equal to $100 for each day such report is not filed, 
unless an extension has been granted by the commissioner. In no event shall the monetary fine imposed exceed $5,000. A QIC notified by the Department that 
such report is overdue by more than 50 days shall have 30 days from the date of such notification to file the delinquent report. If the delinquent report is not 
filed within 30 days after notification, the commissioner shall disallow the business organization's QIC status for any tax period for which a timely report has not 
been filed. 

RECORD KEEPING 
All of the normal tax administration powers given to the Department with respect to other taxes and taxpayers are also applicable to 
QIC's. In accordance with the provisions of RSA 77-A:5-b, IV, QIC's are subject to the requirements of RSA 77-A:11 and RSA 77-E:10. Such organizations must 
comply with the standard record keeping and availability of records for audit requirements that apply to other NH business taxpayers. 

NEED HELP? 
For more information concerning this report you may call the Taxpayer Services Division at (603) 230-5000. 

NEED FORMS? 
To obtain the form needed to file this report visit our web site at www.revenue.nh.gov, or call the forms line at (603) 230-5001. 

                                                      STEP BY STEP INSTRUCTIONS

STEP 1 
Enter the taxable period begin and end dates; name, address and federal employer identification number of the business entity submitting this report in the 
spaces provided. 

STEP 2 
Enter the aggregate amount of funds invested in the QIC as of the period end; the names, addresses, federal employer identification numbers or social security 
numbers of holders of the company and their proportional share of income. If there are more than 5 QIC interest holders please attach a supporting schedule. 

STEP 3  
Enter the name, address and federal employer identification number of the manager of the QIC, if any. 

STEP 4  
Enter the amount of income received and expenses incurred by the QIC in the taxable period. Attach supporting schedules as necessary. 

STEP 5 
Do not check the box in Step 5 unless a copy of the federal return is being submitted with this report. 

STEP 6 
Signature of the duly authorized representative (in ink) . Indicate the title of the representative and the date. If the report is prepared by someone other than 
the duly authorized representative please sign, in ink, and give federal employer identification number, address and the date.

    AU-208   202  3                                                                                                                   Page 3 of 4
    Version 1  8  0 /2023

                     New Hampshire  
                     Department of     AU-208
                 Revenue Administration

                     STEP BY STEP INSTRUCTIONS - continued 

OR IF FEDERAL TAX RETURN IS ATTACHED: 
STEP 1 
Enter the taxable period begin and end dates; name, address and federal employer identification number of the business entity submitting this report in the 
spaces provided. 

STEP 2 - 4 
Attach a copy of federal income tax return as filed with the Internal Revenue Service for the tax period. 

STEP 5  
Indicate by checking the box that the federal return is being submitted with this report. 

STEP 6 
Signature of the duly authorized representative (in ink). Indicate the title of the representative and the date. If the report is prepared by someone other than the 
duly authorized representative please sign, in ink, and give federal employer identification number, address and the date. 

AU-208   202  3                                                                                                            Page 4 of 4
Version 1  8  0 /2023