1. (a) Every new member of the system shall complete Section A of Form NHRS 1 by providing the following information:

   1. (1) The member’s Social Security number;
   2. (2) The member’s name;
   3. (3) The member’s mailing address;
   4. (4) The member’s date of birth; and
   5. (5) The member’s gender.

2. (b) Every employer of the system shall complete Section B of NHRS Form 1 by providing the following information:

   1. (1) The member’s billing account number;
   2. (2) Date of the member’s first eligibility for membership;
   3. (3) The membership classification;
   4. (4) The member’s position title;
   5. (5) The member’s annual salary;
   6. (6) The number of weeks the member worked each year;
   7. (7) The number of hours the member worked each week;
   8. (8) The employer’s name; and
   9. (9) The employer’s address.

3. (c) If membership is optional as in the case of elected, appointed or unclassified officials, every employer shall attach the following documents to NHRS Form 1:

   1. (1) A copy of the member’s Social Security card or IRS Form W-9;
   2. (2) A certified copy of the member’s birth certificate; and

   3. (3) A Designation of Death Beneficiary form.

      [if gte vml 1]><v:line id="_x0000_s1044" style='position:absolute;left:0;text-align:left;z-index:251645952' from="-162pt,-81pt" to="-117pt,135pt"> <v:stroke endarrow="block"/> </v:line><![endif]if !vml?endif?[if gte vml 1]><v:line id="_x0000_s1043" style='position:absolute;left:0;text-align:left;z-index:251644928' from="-306pt,-36pt" to="-135pt,99pt"> <v:stroke endarrow="block"/> </v:line><![endif]if !vml?endif?[if gte vml 1]><v:shapetype id="_x0000_t202" coordsize="21600,21600" o:spt="202" path="m,l,21600r21600,l21600,xe"> <v:stroke joinstyle="miter"/> <v:path gradientshapeok="t" o:connecttype="rect"/> </v:shapetype><v:shape id="_x0000_s1042" type="#_x0000_t202" style='position:absolute; left:0;text-align:left;margin-left:-441pt;margin-top:-36pt;width:333pt; height:45pt;z-index:251643904'> <v:textbox style='mso-next-textbox:#_x0000_s1042'/> </v:shape><![endif]if !vml? endif?if !mso? endif? Here and below where social security numbers are required: By virtue of RSA-A:22, III(g), no state agency shall require a social security number, unless mandated by state or federal law. We found no such mandate in this case. if !mso? endif?if !mso & !vml? endif?if !vml? endif? (d) Every employer shall certify that the member works for the employer and that deductions will be made from the member’s compensation by listing the official’s name, title, signature and date of completion.

      endif?if !mso? endif? Here and below where social security numbers are required: By virtue of RSA-A:22, III(g), no state agency shall require a social security number, unless mandated by state or federal law. We found no such mandate in this case. if !mso? endif?if !mso & !vml? endif?if !vml?	endif? Here and below where social security numbers are required: By virtue of RSA-A:22, III(g), no state agency shall require a social security number, unless mandated by state or federal law. We found no such mandate in this case. if !mso?
      endif? Here and below where social security numbers are required: By virtue of RSA-A:22, III(g), no state agency shall require a social security number, unless mandated by state or federal law. We found no such mandate in this case. if !mso?

      Here and below where social security numbers are required: By virtue of RSA-A:22, III(g), no state agency shall require a social security number, unless mandated by state or federal law. We found no such mandate in this case.

   4. (e) The member shall sign and date this form.

      [if gte vml 1]><v:shape id="_x0000_s1041" type="#_x0000_t202" style='position:absolute;left:0; text-align:left;margin-left:-243pt;margin-top:3pt;width:81pt;height:99pt; z-index:251642880'> <v:textbox style='mso-next-textbox:#_x0000_s1041'/> </v:shape><![endif]if !vml? endif?if !mso? endif? Edit. Replace comma with semicolon after “certificate”. if !mso? endif?if !mso & !vml? endif?if !vml? endif? (f) The employer shall retain the yellow copy of NHRS Form 1, return the pink copy of NHRS Form 1 to the member and return the white copy of NHRS Form 1 to the system.

      endif?if !mso? endif? Edit. Replace comma with semicolon after “certificate”. if !mso? endif?if !mso & !vml? endif?if !vml?	endif? Edit. Replace comma with semicolon after “certificate”. if !mso?
      endif? Edit. Replace comma with semicolon after “certificate”. if !mso?

      Edit. Replace comma with semicolon after “certificate”.

Source. #7574, eff 10-10-01, EXPIRED: 10-10-09 New. #9563, eff 10-14-09, EXPIRED: 10-14-17