New Hampshire                              202  
                             Department of                                                  *000BET2411862*
                                                                          BET
                     Revenue Administration                                                              000BET2411862

                                               BUSINESS ENTERPRISE TAX RETURN
Taxpayer Name

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

You are required to file this return if the gross business receipts were greater 
                                                                                            Check here if required to file Form BET-80 
than $2  ,000 or the enterprise value tax base is greater than $2  ,000.

                                                                                                            306/% 50 5)& /&"3&45 8)0-& %0--"3
Total Gross Business Receipts for this business organization

1.  Dividends Paid                                                                                        1

2. Compensation and Wages Paid or Accrued                                                                  2

3.  Interest Paid or Accrued                                                                              3

4. Taxable Enterprise Value Tax Base (Sum of Lines 1, 2, and 3)                                   4

5. New Hampshire Business Enterprise Tax  (BET) (Line 4 multiplied by .0055) before credits                5

6. Enter credits against BET.  Use DP-160 to determine credit against BET                                  6

7. Enter Tax Due (Line 5 minus 6).  If negative, enter Zero. Report on BT-SUMMARY Line 1(a) TAX DUE     7

     BET 202                                                                                                                   Page 1 of 
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