2023 Capital Credit Retirement Information

Please fill out the form below in order for NHEC to issue your capital credit retirement. If the form is not filled out properly, we will not be able to process your capital credits correctly.
Are you the person whose name is listed on the letter you received from NHEC?(Required)
*If you answered yes and are the person listed on this letter, please continue filling out the remaining information on this form.
*If you answered no please stop here and return this letter to NHEC in order for us to update our records.
*If you answered no but indicated you are the heir or beneficiary, please email: capitalcredits@nhec.com with any estate or trust paperwork noting you are the designated beneficiary or call 1-800-698-2007 and reference the letter you received.

Name (as listed on the letter)(Required)
Address (as listed on the letter)(Required)

If the address listed on the letter is NOT your CURRENT mailing address, please provide that information below:
Current Mailing Address

Are you interested in donating your capital credit refund?(Required)
If you selected that you would like to donate your return, please select one or both charities to be the beneficiary.
**PLEASE NOTE: IF YOU CHOOSE TO DONATE, WE WILL CONTINUE TO DONATE ANY FUTURE CAPITAL CREDIT REFUNDS YOU MAY RECEIVE UNLESS YOU NOTIFY NHEC OTHERWISE AT CAPITALCREDITS@NHEC.COM**
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