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                           New Hampshire                                       CD-100
                           Department of      Meals & Rentals Request to 
                     Revenue Administration
                                              Update or Change License                                                *0CD1002311862*
                                                                                                                                   0CD1002311862
Business Name (DBA)        COOL RUNNINGS                                                                                   Operator License Number                  5 6    4        8 9 5
Notice is hereby given to the New Hampshire Department of Revenue Administration that the information for the license number listed above  
changed. The licensee is requesting the following change in filing requirements and/or providing the updated changes as prescribed in RSA 78-A. A 
separate Form CD-100 must be submitted per location. Please list changes below.
Change in Contact Information
     Business Name (DBA)
1.   COOL RUNNINGS
     Mailing Address
2.   82 SOUTH ST 
     City / Town                                                               State                                  Zip Code + 4 (or Canadian Postal Code)
     CONCORD                                                                   NH                                     0 3 3 0 1
     Telephone Number                     E-Mail Address 
3.   6 0 3       5   2     1 5 2 1 5 4.   TEST@TEST.COM
     Contact Person Last Name                 Contact Person First Name                                               Title                                         Telephone Number
5.   STEVENS                                  RENEE                                                                   MANAGER                                       6 0 3 6 3 2 6 6 5 5
     NH Banking Institution                                                          Account Holder Name
6.   SERVICE BANKING                                                                 RENEE STEVENS

Change in Business Status (by location)
NOTE: You must surrender your current Meals & Rentals Tax License with this form if you have filled out any part of this section.
                                                                       MMDDYYYY
 7.    Business uses only a facilitator as of 
                                                                                                                                                            MMDDYYYY
  8.   Business at this location suspended or discontinued entirely, without a new owner as of 
                                                                                                              MMDDYYYY
  9.   Business at this location continued without taxable sales as of               0 8 2                            1 2 0 2 3
                                                                                                              MMDDYYYY
 10.   Business at this location was acquired by a new owner as of
     Name of New Owner                                                         New Owner Contact Person Last Name                  Contact Person First Name          Title

     Address of New Owner                                                                                                                                           Telephone Number

     City / Town                                                               State                                  Zip Code + 4 (or Canadian Postal Code)
                                                                                
                                                                                                              MMDDYYYY
11.    Business moved to a new location (not a new owner) as of 
     New Location Address

     City / Town                                                               State                                  Zip Code + 4 
                                                                                
     NOTE: A Form CD-3 must be submitted to request a new Meals & Rentals Tax License if box 10 or 11 is checked.

       CD-100  2023 
       Version 1.1 04/2023     Mail To: NH DRA, COLLECTIONS DIVISION, PO BOX 454, CONCORD, NH 03302-0454                                                                   Page 1 of 2

                           New Hampshire                    CD-100
                           Department of   Meals & Rentals Request to 
                     Revenue Administration
                                           Update or Change License                *0CD1002321862*
                                                                                                  0CD1002321862
Change in Partners, LLC Managers and Members, or Corporate Officers and Any Other Person in a Managerial Capacity 
       Last Name and Suffix               First Name                MI             Title                        Social Security Number
12(a). EVANS                              RON                       S              CFO                          4 5 6 4 5 6 1 2 4
       Residence Address - No PO Boxes                                 Telephone Number
                                                                                                                Add
       77 MUSIC LANE                                                               6 0 3 4 5 4 6 5 1 4          OR
       City / Town                                      State     Zip Code + 4 (or Canadian Postal Code)        Remove  
       HENNIKER                                         NH        0 3 2 4 2

       Last Name and Suffix               First Name                MI             Title                        Social Security Number

12(b).
       Residence Address - No PO Boxes                                 Phone Number

                                                                                                                Add
                                                                                                                OR
       City / Town                                      State     Zip Code + 4 (or Canadian Postal Code)        Remove  
                                                         
                                           If additional space is needed attach a schedule
Request to File as a Seasonal Operator or to Change Seasonal Months (Rev 706.04)
13.    I request permission to file as a seasonal operator.       Please specify the seasonal months  for which you request 
                                                                  permission to file Meals & Rentals Tax returns, if you 
14.    I request permission to change my seasonal months.         checked box 13 or 14.
                                                                    Jan Feb Mar Apr May Jun Jul                Aug Sep Oct Nov Dec
NOTE:  You may not change your current filing requirements until 
your request is granted by the Department of Revenue Administration.
15.    The status of my business has changed from seasonal to year-round operation.
       NOTE: You must complete and file monthly Meals & Rentals Tax returns if you checked box 15.

Request to File Quarterly Returns (Rev 706.03)
16.    I request permission to file quarterly returns, and certify that: (1) my business is an operational, year-round business; (2) my business has 
       been in operation for a full year prior to this request; (3) my business is in full compliance with all provisions of RSA 78-A, including Rev 
       700; and (4) the average Meals & Rentals Tax liability of my business was less than $100 per month for the calendar quarter immediately 
       preceding this request.
NOTE:  You may not change your current filing requirements until your request is granted by the Department of Revenue Administration.

Signatures
I declare under penalties of perjury that I am authorized to sign on behalf of the business entity, that I have examined all of the information provided 
on this form, and that the information is true, correct, and complete to the best of my knowledge and belief.

Signature (in ink) of Authorized Officer/Representative                MMDDYYYY
                                                                                   1 0    0 2 2   0          2 3

Print Signatory Name & Title
RENEE STEVENS MANAGER

       CD-100  2023         Mail To: NH DRA, COLLECTIONS DIVISION, PO BOX 454, CONCORD, NH 03302-0454
       Version 1.1 04/2023                                                                                      Page 2 of 2