UNITED STATES DISTRICT COURT DISTRICT OF NEW HAMPSHIRE ______________________ Plaintiff(s) v. Civil Case No. and Judge’s Initials ______________________ Defendant(s) DISCLOSURE STATEMENT LOCAL RULE 7.5 [This form is to be completed and filed only by parties that are nongovernmental corporations, partnerships, or limited liability companies. Check the appropriate box(es).] w The filing party, a nongovernmental corporation, identifies the following parent corporation and any publicly held corporation that owns 10% or more of its stock: w The filing party, a partnership, identifies the following parent corporation and any publicly held corporation that owns 10% or more of the corporate partner's stock: w The filing party, a limited liability company (LLC), identifies the following parent corporation and any publicly held corporation that owns a 10% or more membership or stock interest in the LLC: American LegalNet, Inc. www.FormsWorkFlow.com w The filing party identifies the following publicly held corporations with which a merger agreement exists: w The filing party has none of the above. Respectfully Submitted, [Name of Corporation/Partnership/LLC] s/ [Name of Password Registrant] [Name of Password Registrant] [Bar No.] [Law Firm Name] [Address] [City, State, Zip Code] [Phone: (999) 999-9999] [E-mail: xxx@xxx.xxx] Date: ***the following need not be completed if submitted with civil complaint*** CERTIFICATE OF SERVICE I hereby certify that this Disclosure Statement was served on the following persons on this date and in the manner specified herein: Electronically Served Through ECF: [Names of Filing Users] Conventionally Served: [Name and Address of Non-Filing Users] ______________________ Date _____________________________________ /s/Signature American LegalNet, Inc. www.FormsWorkFlow.com