New Hampshire Employment Agency

Employee Leasing Initial Application

If domiciled in New Hampshire: $100 application fee + $500 license fee

If not domiciled in New Hampshire: $100 application fee + $500 or the amount required by the domiciliary state, whichever is greater

• Criminal Record Release Authorization Forms for each individual in paragraph 2 of the application
• A document signed by the parent company agreeing and guaranteeing the direct payment of benefits if the applicant fails or defaults in its obligation to do so. (Subsidiaries only)
• A copy of the applicant’s workers’ compensation policy covering all leased employees of the applicant
• A list of clients with their name, business address, FEIN, number of employees in NH and name of workers’ compensation carrier
• Evidence satisfactory to the commissioner that any health insurance benefits covering leased employees are provided pursuant to provisions of RSA 277-B:11, II (Example: Letter stating where health insurance is provide and who the carrier is)
• An audited financial statement prepared by an independent Certified Public Accountant in accordance with generally accepted account principles within twelve (12) months prior to the date of application which statement shall show a minimum working capital of $100,000 per RSA 277-B:6, I
• A copy of the employee manual provided to the leased employee outlining the terms and conditions of employment with the leasing company per RSA 277-B:9, I(i)
• Confirmation from home state, if other than NH, that the leasing company is in good standing
• A copy of the applicant’s license issued by its State of domicile or a letter stating the state does not issue license, if the applicant is not a NH resident or domiciliary
• A letter signed by the principle on the application certifying that the applicant does not conduct a temporary help service through the same entity as the applicant’s employee leasing company
• Letter of Good Standing from the NH Department of Employment Security
• Letter of Good Standing from the NH Department of Revenue regarding Business Profit Tax
• Any open or unpaid Civil Penalties or violations with Coverage Unit or Inspections

Employee Leasing Renewal Application

If domiciled in New Hampshire: $100 application fee + $500 license fee

If not domiciled in New Hampshire: $100 application fee + $500 or the amount required by the domiciliary state, whichever is greater

Licenses expire annually on the date of issuance. Renewal applications must be filed at least 60 days prior to the expiration date.

Licensees may elect a two-year renewal cycle after 5 or more years of being licensed in New Hampshire.

• Criminal Record Release Authorization Forms for each individual in paragraph 2 of the application
• A document signed by the parent company agreeing and guaranteeing the direct payment of benefits if the applicant fails or defaults in its obligation to do so. (Subsidiaries only)
• A copy of the applicant’s workers’ compensation policy covering all leased employees of the applicant
• A list of clients with their name, business address, FEIN, number of employees in NH and name of workers’ compensation carrier
• Evidence satisfactory to the commissioner that any health insurance benefits covering leased employees are provided pursuant to provisions of RSA 277-B:11, II (Example:
• Letter stating where health insurance is provide and who the carrier is)
• An audited financial statement prepared by an independent Certified Public Accountant in accordance with generally accepted account principles within twelve (12) months prior to the date of application which statement shall show a minimum working capital of $100,000 per RSA 277-B:6, I
• Quarterly Tax Certification from a Certified Public Accountant per RSA 277-B:6,III
• A copy of the employee manual provided to the leased employee outlining the terms and conditions of employment with the leasing company per RSA 277-B:9, I(i)
• Confirmation from home state, if other than NH, that the leasing company is in good standing
• A copy of the applicant’s license issued by its State of domicile or a letter stating the state does not issue license, if the applicant is not a NH resident or domiciliary
• A letter signed by the principle on the application certifying that the applicant does not conduct a temporary help service through the same entity as the applicant’s employee leasing company
• Letter of Good Standing from the NH Department of Employment Security
• Letter of Good Standing from the NH Department of Revenue regarding Business Profit Tax
• Any open or unpaid Civil Penalties or violations with Coverage Unit or Inspections

$0

Within 60 days after the end of each calendar quarter.

NH Stat. § 277-B:6

Every quarter employee leasing companies must submit a certification by an independent certified public accountant that for such quarter all applicable federal and state payroll taxes have been paid on a timely basis.