UNITED STATES DISTRICT COURT DISTRICT OF NEW HAMPSHIRE Civil No. ________________ WRIT OF EXECUTION TO THE MARSHAL OF THE UNITED STATES DISTRICT COURT, DISTRICT OF NEW HAMPSHIRE: WHEREAS, judgment was entered on the ___ day of ___________________, 20__, in an action in the United States District Court, in favor of ___________________________________ (“judgment creditor”) against ______________________________________________________ (“judgment debtor”) in the sum of $ __________________, plus costs taxed at $ ____________ , as it appears on the record, and execution remains to be done; I COMMAND YOU, therefore, to levy upon the money, goods, chattels, lands, personal estate, property interest, right or credit of the above said judgment debtor(s) found in this district [found anywhere in the United States if the government is the judgment creditor], as set forth in the attached affidavit, and to pay to the judgment creditor(s) named or their attorney the above sum stated, with lawful interest thereon, and also to pay your own fees, and to return the writ, stating the results of your doings, to this court not later than six (6) months after the date of its issuance. I COMMAND THE JUDGMENT CREDITOR, or their counsel, to accompany the United States Marshal should it be necessary during the execution of this writ, to answer any questions that may arise during execution, and, unless otherwise ordered by the court, to serve as the substitute custodian over and maintain direct responsibility for the custody of any property levied upon by the United States Marshal. A substitute custodian shall hold the United States Marshal harmless for any damage to the seized property while in their custody. I FURTHER COMMAND THE JUDGMENT CREDITOR to compensate the United States Marshal for fees and expenses incurred during the execution of this writ to the extent not satisfied through the levy process. WITNESS, the Honorable Joseph N. Laplante, Chief Judge of the United States District Court, District of New Hampshire, this ___ day of ____________________, 20__. Judgment Costs Interest $ ____________________ $ ____________________ $ ____________________ TOTAL $ ____________________ ____________________________________ James R. Starr, Clerk of Court United States District Court USDCNH-85 (rev. 11-11) American LegalNet, Inc. www.FormsWorkFlow.com NOT INCLUDING M ARSHAL’S EXECUTION FEES Prepared By: __________________________________ Attorney Address: __________________________ __________________________________ __________________________________ __________________________________ RETURN DATE RECEIVED DATE OF EXECUTION OF W RIT This writ was received and executed. U.S. MARSHAL (BY) DEPUTY MARSHAL USDCNH-85 (rev. 11-11) American LegalNet, Inc. www.FormsWorkFlow.com ATTACHMENT TO WRIT OF EXECUTION AFFIDAVIT IN SUPPORT OF WRIT OF EXECUTION I, ______________________________________, being duly sworn, submits this affidavit in compliance with LR 69.1: 1. I am the judgment creditor/attorney for the judgment creditor in the case of: 2. Below is a statement outlining efforts made to recover judgment: 3. I certify that demand has been made to satisfy the judgment. 4. Below is a statement outlining any amounts paid and the amount still owing on the judgement: 5. If the principal amount the affiant claims is owed differs from the amount awarded in the judgment, below is a statement to explain that difference: USDCNH-85 (rev. 11-11) American LegalNet, Inc. www.FormsWorkFlow.com 6. I certify that the amount relfected on the Writ of Execution is the amount due. 7. I have caused to be conducted an examination of the assets of judgment debtor and determined the following non-exempt real and/or personal property of the judgment debtor is subject to execution in satisfaction of the judgment therein: Property Description 1. 2. 3. 4. Property Location 1. 2. 3. 4. ____________________ Date ________________________________________ Affiant Signature STATE OF _____________________ COUNTY OF ___________________ Personally appeared the person signing the above affidavit and swore that it is true to the best of the affiant’s knowledge and belief. ____________________ Date _________________________________________ Notary Public/Justice of the Peace USDCNH-85 (rev. 11-11) American LegalNet, Inc. www.FormsWorkFlow.com