Get Nh 2637 2011-2025

Filling out the NH 2637 form is an essential step for enrolling in direct deposit with the New Hampshire Department of Health and Human Services. This guide provides clear, step-by-step instructions tailored for users of all experience levels.

Follow the steps to complete your NH 2637 form online.

1. Click ‘Get Form’ button to access the NH 2637 form and open it in your online editor.
2. In section 1, choose the type of transaction by selecting either 'new' or 'terminate.' Fill in your provider name, and if applicable, your doing business as (DBA) name.
3. Enter the employer identification number (EIN) or social security number (SSN) as required based on your enrollment status, along with your address, city, state, and ZIP code.
4. Provide your Bridges Resource ID numbers and telephone number. Ensure all information is accurate and complete.
5. In section 1, certify your understanding of the form by signing and dating it.
6. Proceed to section 2, where you will need to fill in your bank's routing number, the name and address of your bank, and the account holder's name.
7. Enter your depositor account number and specify the type of deposit account (checking or savings).
8. If required, attach a copy of a voided check or savings deposit slip to this form.
9. Review all the entered information for accuracy and completeness.
10. After verifying the form, save your changes, download a copy for your records, and print or share the form as necessary. Mail the original signed form to the appropriate address.

Complete your NH 2637 form online today for easy access to your payments!