New Hampshire Code of Administrative Rules
Saf - Department of Safety
Subtitle Saf-C - Commissioner, Department of Safety
Chapter Saf-C 4600 - CARRIAGE OF HOUSEHOLD GOODS BY MOTOR VEHICLES
Part Saf-C 4605 - FORMS
Section Saf-C 4605.01 - Application Form

(a) Each applicant for a permit or certificate pursuant to RSA 359-T shall complete and submit form DSAD 5-H, "New Household Goods Carrier Operations", (rev. 12/23), along with the application fee required by RSA 359-T:5, III and RSA 359-T:18, I(a).

(b) The applicant shall attach a copy of the certificate of registration filed with the secretary of state pursuant to the provisions of RSA 349:1.

(c) The applicant shall attach a certificate of insurance that is compliant with Saf-C 4602.02.

(d) The applicant shall sign the application form under the penalty of unsworn falsification pursuant to RSA 641:3 and by doing so shall certify that the applicant is authorized to file the application and the exhibits attached thereto, that all of the application and exhibits are true and correct to the best of the applicant's knowledge and belief, and that the applicant shall comply with all rules prescribed by the bureau of road toll operations and the state's motor carrier safety rules.