Effective Date of the Transaction Add Change Close month day year Resource Identification Number (Use on change/close transactions only) SECTION 1 PROVIDER S NAME (Please Note: If you are reporting income with a Social Security Number, use your name here not the name of your business. If you are reporting income with an Employer Identification Number, use your business name here.) DOING BUSINESS AS (DBA) Complete this line only if you report income to the IRS under your Social Security.
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How to fill out the Nh Dhhs Child Care Provider Link Form online
Filling out the Nh Dhhs Child Care Provider Link Form online is essential for anyone looking to provide child care services in New Hampshire. This guide will walk you through the various sections of the form, ensuring that you complete it accurately and efficiently.
Follow the steps to complete the form online.
- Click the ‘Get Form’ button to retrieve the form and open it in your preferred digital document management tool.
- In the transaction code section, select one option by checking the corresponding box: 'Add' for new enrollment, 'Change' for reporting changes, or 'Close' to request an end to your enrollment.
- Enter the effective date of the transaction in the provided fields for month, day, and year to indicate when your enrollment or changes will take effect.
- If you have a Resource Identification Number, provide it here; this is particularly needed for changes or closures.
- Complete Section 1 by entering your name if reporting income under your Social Security Number. If using an Employer Identification Number, enter your business name instead.
- Fill out the 'Doing Business As' (DBA) line only if reporting income with your Social Security Number and having a business name. Complete your name above in this case.
- In Section 2, fill out your physical address, including street, town/city, state, and zip code. Also enter your billing or mailing address as payments will be directed there.
- Provide your email address and contact person’s details, including their first and last name and telephone number.
- In Section 3, indicate the type of child care service you provide by checking the appropriate box.
- After reviewing and confirming that all required fields are accurately completed, save your changes. You can then download, print, or share the completed form as needed.
Begin the process of completing the Nh Dhhs Child Care Provider Link Form online today!
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