Get Dp 156 Fillable Form

The Dp 156 Fillable Form is essential for nursing facilities in New Hampshire to report their quality assessment. This guide provides clear, step-by-step instructions for completing the form online, ensuring accuracy and compliance with state requirements.

Follow the steps to successfully complete the Dp 156 Fillable Form online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Enter the nursing facility name, address, and federal employer identification number in the designated fields.
3. Select the return type by checking the appropriate box for either Initial Return, Amended Return, or Final Return, indicating the last day of business if necessary.
4. Calculate your assessment by entering your net patient services revenues on Line 1 and multiplying by the assessment rate of 5.5% for Line 2.
5. For credits, enter any payments made with extension, credits carried over, and original return payments on Lines 3(a), 3(b), and 3(c) respectively. Calculate the total credits and enter it on Line 3.
6. Determine your balance due by subtracting the total credits (Line 3) from your assessment (Line 2) and entering the result on Line 4.
7. Input any additions such as interest or penalties on Lines 5(a), 5(b), and 5(c), and calculate the total to be entered on Line 5.
8. Finalize your payment details by adding the balance due from Line 4 to any totals from Line 5 to reach the total balance due on Line 6.
9. If applicable, complete Step 6 for amended returns, by filling in the payment made by electronic transfer and any overpayment details only if you are filing an amended return.
10. Sign the form in ink where indicated, ensuring signatures are from authorized representatives. Then save your changes, download, print, or share the final form as needed.

Complete your Dp 156 Fillable Form online today for timely submission and compliance.