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Get NH Form 2602 2012-2024

71-4729 TDD Access: 1-800-735-2964 Nicholas A. Toumpas Commissioner Maggie Bishop Director NEW HAMPSHIRE HEALTH AND HUMAN SERVICES CRIMINAL HISTORY RECORD INFORMATION AUTHORIZATION LICENSE EXEMPT CHILD CARE FORM NH RSA 170-E:4 LIVESCAN-$16.50 or must select one INKED-$16.50 NEW APPLICANT (Fingerprints are required) or RENEWAL (Fingerprints NOT required) APPLICANTS ARE RESPONSIBLE FOR THIS FEE SECTION I PLEASE TYPE OR PRINT CLEARLY, ALL INFORMATION IN THIS SECTION MUST BE COMPLETED NAME L.

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