Fillable Online Are You a Customer or Client - NH.gov Fax ... 2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name in the designated field labeled 'Name of Consumer (Please Print)'. This ensures that your identity is clearly documented.
  3. Next, review the sections regarding customer and client relationships. Familiarize yourself with the rights and services associated with each status.
  4. Sign the form in the 'Signature of Consumer' field. Make sure to date your signature accurately.
  5. If applicable, have your licensee complete their information and sign as well. This step is crucial for validating the document.
  6. Finally, ensure all fields are filled out correctly before submitting or saving your completed form.

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Income Requirements: For adults, income up to 138% of the FPL ($2,264 per month) for a family of three. For blind or disabled adults, making less than $5,974 per month and have less than $40,855 in assets. For disabled children and pregnant women, income up to 196% of the FPL ($3,336 per month) for a family of three.
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