N.H. Admin. Code § Emp 409.06

Current through Register No. 2, January 9, 2025

Section Emp 409.06 - Contents of Request For Forbearance

(a) A request for forbearance by an individual shall be in writing and shall include:

(1) The individual's name and address;

(2) An explanation of the reasons why the individual believes that the amount of the offset or proposed offset will cause extreme financial hardship to the individual or a member of the individual's immediate family, and copies of any documents that the individual wishes to have considered in support of the individual's claim of extreme financial hardship;

(3) An alternative offset proposal, if any;

(4) The following information:

a. Current marital status;

b. Tax filing status for the tax year in question;

c. Income from all sources;

d. Assets;

e. Liabilities;

f. Names and ages of dependents;

g. Expenses for food, housing, heat, electricity, water, clothing, and transportation;

h. Medical expenses; and

i. Exceptional expenses, if any;

(5) Documents as requested by the department in connection with the request for forbearance;

(6) Copies of all documents that the individual wishes to have considered to support the objections raised by the individual regarding the claim of extreme financial hardship;

(7) Certification that all statements and attachments are true to the best of the individual's knowledge and belief; and

(8) The individual's signature.

(b) The individual may submit the information required in (a) on a Request for Forbearance of Federal Income Tax Refund form provided by the department. The department shall make such a form available to the individual upon request, or if the request for forbearance is incomplete.

(c) The individual shall provide the department with the documentation and information described in Emp 409.06 (a) within 20 days of the department's request for such documentation and information, unless sufficient grounds for extension of the 20 days is shown.

(d) For purposes of this section, sufficient grounds shall include any unforeseeable circumstance beyond the individual's control that prevented the individual from making a timely request for reconsideration.

N.H. Admin. Code § Emp 409.06

#10424, eff 9-27-13

Amended by Number 24, Filed June 13, 2024, Proposed by #13965, Effective 5/16/2024, Expires5/16/2034.