Statement For Payment {NHJB-2154-P}

THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) v. Plaintiff/Petitioner Defendant/Respondent PETITION / MOTION TO ATTACH WITH NOTICE The Plaintiff/Petitioner requests permission to make the following attachments: Name of Defendant/Respondent Category of Property to be attached (check one) Real Estate Provide address or book & page reference. Attach additional pages if necessary. Other Amount of attachment $ $ $ In support of this petition, the Plaintiff/Petitioner certifies that he/she believes there is a reasonable likelihood that the Plaintiff/Petitioner will recover the amount stated above, including interest and costs, in the amount of $ . Date Plaintiff/Petitioner Signature (If petitioner is a corporation or partnership, a duly authorized officer or partner shall sign.) State of This instrument was acknowledged before me on My Commission Expires Affix Seal, if any , County of by Signature of Notarial Officer / Title NHJB-2316-DPS (10/25/2010) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: PETITION TO ATTACH WITH NOTICE V. NOTICE TO DEFENDANT/RESPONDENT The Plaintiff/Petitioner intends to attach your property to secure any judgment or decree the Plaintiff/Petitioner may obtain in this action. You have the right to object in writing to this attachment, ask for a hearing and request that the attachment not be made. If you fail to file such a request by the return date of , you will be deemed to have waived your right to a hearing with reference to the attachment, but not with reference to the merits of the petitioner's claim. If you transfer any property after receiving this notice, and before the attachment, if allowed, is made, you will be subject to the provisions of RSA 511-A:6. Even if you do not object to the attachment, you should file an appearance with the court by ; otherwise, the Petitioner/Plaintiff may obtain a judgment by default. (return date) Date Plaintiff/Petitioner or Plaintiff/Petitioner Attorney ORDER Petition / motion to attach is denied. Petition / motion to attach is granted. The petitioner is granted permission to make the above attachment(s) within days. Petition / motion to attach is granted subject to the following modifications: Date Judge NHJB-2316-DPS (10/25/2010) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com