DO NOT STAPLE                                                                                           Print Form                    Reset Form
                       New Hampshire
                                                                202 3
                       Department of                                                         *0BTSUM2311862*
                      Revenue Administration                 BT-SUMMARY
                                                                                                                   0BTSUM2311862

                                                      BUSINESS TAX RETURN SUMMARY
STEP 1  -  PRINT OR TYPE                                        MMDDYYYY                                           MMDDYYYY
For the CALENDAR year 202  3 or other taxable period beginning: 0        1 0 1 2 0  2        3   and ending:         1 2       3 1 2  0      2 3

Check box if there has been a name change since last filing.  List former name.

Proprietor's Last Name
                                                                                                                                   If issued a DIN,  
LANDEN                                                                                                                           use the DIN in the 
First Name                                                   MI          Social Security Number                                appropriate taxpayer 
                                                                                                                                 identification box. 
ERIC                                                         S               1 2 3  4        5 6 7      8 9          DO NOT enter SSN or FEIN if 
                                                                                                                                   you have a DIN
Corporate, Partnership, Estate, Trust, Non-Profit or LLC Name

Taxpayer Identification Number  Principal Business Activity Code (Federal)

Number & Street Address

Address (continued)                                                                                                                Unit Type     Unit #
1067 PINE HILL RD                                                                                                                  Unit          5
City / Town                                                                   State            Zip Code + 4 (or Canadian Postal Code)
SALEM                                                                         NH               0 3 0 7 9 -           3 2 5 1

STEP 2  -  Return Type and Federal Information                  Are you required to file a BET Return (Gross Business Receipts 
                                                                                                                                                Yes       No
                                                                over $281,000, or Enterprise Value Tax Base over $281,000)? 
If  you checked "yes" to one or both of the first two           Are you required to file a BPT Return (Gross Business Income over $103,000)?    Yes       No
questions, you must file the completed corresponding 
return(s) with this BT-Summary.                                 Do you file a Form 990/990T?                                                    Yes       No
                                                                Do you file a Federal Form 8023, Federal Form 8883 and/or have checked box 
                                                                10b on Schedule B of Federal Form 1065?                                         Yes       No

                                                                Is the business organization filing its return on an IRS approved 52/53 week 
                                                                                                                                                Yes       No
                                                                tax year?

            2 - CORPORATION          3 - PARTNERSHIP                         1 - PROPRIETORSHIP                             AMENDED RETURN
OR                                                                                                                                                   LLC
            6 - COMBINED GROUP       5 - NON-PROFIT                          4 - FIDUCIARY                                  FINAL RETURN

IRS Adjustment: A complete federal Revenue Agent Report (RAR) with all applicable Schedules must be included with a complete amended NH tax 
return. Do not use this form to report IRS adjustments for taxable periods ending on or before December 31, 2020.

     BT-SUMMARY 202 3
     Version 1 07 /2023
                                                                                                                                               Page 1 of 3

                         New Hampshire
                                                                             202 3
                            Department of                                                           *0BTSUM2321862*
                        Revenue Administration                  BT-SUMMARY
                                                                                                                     0BTSUM2321862

                                                  BUSINESS TAX RETURN SUMMARY - Continued

STEP 3  -  Complete the BET and / or BPT return(s) and then complete the BT-Summary and attach return(s)

STEP 4  -  Calculate Your Balance Due or Overpayment                                                                 Round to the nearest whole dollar

 1   (a)  Business Enterprise Tax Net of Statutory Credits         1(a)                             2   3 6     0

   (b) Business Profits Tax Net of Statutory Credits               1(b)                             5   3 7     0

   (c) Subtotal of Business Tax Due (Line 1(b) plus Line 1(a))                                                  1(c)              7 7                 3 0
 2   PAYMENTS      

   (a) Tax paid with application for extension                          2(a)                        6   5 8     5

   (b) Total of taxable period's estimated tax payments                 2(b)                            5 0     0

   (c) Credit carryover from prior tax period                           2(c)                            6 4     5

   (d) Tax paid with original return (Amended returns only)             2(d)

   (e) Total of Lines 2(a) through 2(d)                                                                         2(e)              7 7                 3 0

3   TAX DUE: (Line 1(c) minus Line 2(e))                                                                         3

4   ADDITIONS TO TAX

   (a) Interest (See instructions)                                      4(a)

   (b) Failure to Pay (See instructions)                                4(b)                            2 7     5

   (c) Failure to File (See instructions)                               4(c)                            1 2     0

   (d) Underpayment of Estimated Tax (See instructions)                 4(d)

   (e) Total of Lines 4(a) through 4(d)                                                                         4(e)                3                 9 5

5  (a) Subtotal of Amount Due (Line 3 plus Line 4(e))                                                           5(a)                3                 9 5

 (b) Return Payment Made Electronically                                 5(b)
 (c) BALANCE DUE:  Line 5(a) minus 5(b).  Make your payment online at www.revenue.nh.gov/gtc or 
     make check payable to:   STATE OF NEW HAMPSHIRE                             PAY THIS AMOUNT             5(c)                   3                 9 5

6  OVERPAYMENT:  If balance due is less than zero, enter on Line 6              6

 (a) Any amount of overpayment in excess of 500% of Line 1(c) shall be
     refunded (Line 1(c) X 500%).                                            6(a)
7  Apply overpayment amount on Line 6 to:                                                                 DO NOT PAY
   (a) Credit - Next Year's Tax Liability (amount entered shall not exceed Line 6(a))(Not available for Federal RAR) 7(a) 

   (b) Refund (Only option available for Federal RAR)                                                     DO NOT PAY  7(b)

       BT-SUMMARY 202  3                                                                                                          Page 2 of 3
       Version 1 07 /2023

                   New Hampshire
                                                  202 3
                         Department of                                                        *0BTSUM2331862*
                   Revenue Administration  BT-SUMMARY
                                                                                                        0BTSUM2331862

                                  BUSINESS TAX RETURN SUMMARY - Continued
STEP 5
Under penalties of perjury, I declare that I have examined this BT-Summary and the attached returns, and to the best of my belief they are 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. If a combined group, I also certify 
that all affiliated companies are included in the appropriate group described in this return. 
     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
                                                                                              0 1 0   9 2 0 2 4

Print Signatory Name & Title
ERIC LANDEN 
Email Address
ELANDEN@TEST.COM
Phone Number
6  0  3     1 2    3     1  1 1 1   Check this box if you are filing as a surviving spouse

PAID PREPARER'S SIGNATURE & INFORMATION
Signature of Preparer                                                                         MMDDYYYY
                                                                                              0 1 0   7 2 0 2 4
Printed Name of Preparer
STEVEN JOHNSON  
Email Address
JOHNSON.S@TEST.COM
Phone Number                      Preparer Identification Number
6  0  3     1 2    3     4  2 2 2 4    8 7 8 9 4     5 6        1
Preparer's Address
80 MAIN ST 
Address (continued)
UNIT B
City / Town                                                            State                  Zip Code + 4 (or Canadian Postal Code)
NEW MARKET                                                             NH                     0 3 8 5 7 -   1 6 5 4

Mail to:                          Make Check Payable to:   
                                                                                              FILE ONLINE AT GRANITE TAX CONNECT 
NH DRA                            STATE OF NEW HAMPSHIRE 
PO Box 637                      Enclose but DO NOT staple or tape your                          www.revenue.nh.gov/gtc
Concord NH 03302-0637                  attachments

   THIS RETURN MUST BE ACCOMPANIED BY COMPLETE AND LEGIBLE COPIES OF THE APPROPRIATE FEDERAL FORMS AND SCHEDULES

     BT-SUMMARY 202 3
     Version 1 0 /7 2023                                                                                                            Page 3 of 3