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Forms and Instructions - Medicaid Enhancement Tax

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Form Number Name/Description
DP-153 pdf file
See Form for Instructions
Medicaid Enhancement Tax Return (Rev. 09/2014)
DP-153-ACH pdf file
See Form for Instructions
Medicaid Enhancement Tax Authorization Agreement for Electronic Payments (Rev. 09/2014)
DP-153-ES  pdf file
See Form for
Instructions
Medicaid Enhancement Tax Payment Nonbinding Estimate (Rev. 09/2014)

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New Hampshire Department of Revenue Administration
Governor Hugh Gallen State Office Park
109 Pleasant Street (Medical & Surgical Building)
(603) 230-5000  |  
TDD Access Relay NH: 1-800-735-2964  |  
fax: (603) 230-5945
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