NHJB-2054-DF (07/01/2013) Page 1 of 1 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) PNO: MOTION AND AFFIDAVIT FOR RETURN OF DEADLY WEAPONS OTHER THAN FIREARMS Pursuant to RSA 173-B, RSA 633:3-a, or 169-C V. Plaintiff Defendant Def Date of Birth NOW COMES the defendant, , and respectfully represents and requests the following: 1. Pursuant to a Domestic Violence or Stalking Protective Order, or violation of a 169-C Stay Away Protective Order, my deadly weapons (specify: ) was/were relinquished to: Police Department State Police Troop/Unit Fish & Game County Sheriff's Department 2. The Order has expired or will expire on and I would like return of my deadly weapons. 3. I have not been convicted of any felony in any state or federal court (including the District of Columbia, Commonwealth of Puerto Rico, territory or possession), nor am I on probation or parole for any crime, nor am I subject to any bail order prohibiting possession of deadly weapons. 4. My date of birth is , and I was born in the State of 5. My current address and telephone number are: 6. Race: White Black American Indian/Alaskan Native Asian or Pacific Islander Unknown 7. Physical Description: a. Eye Color c. Height (feet) (inches) b. Hair Color d. Weight (pounds) 8. I request a search of all pertinent records to determine whether I am prohibited by RSA 159:3 or otherwise from possessing deadly weapons. 9. I request a hearing on my motion. Date Signature of Defendant State of , County of This instrument was acknowledged before me on by My Commission Expires Affix Seal, if any Clerk of Court/Deputy Clerk/Justice of Peace/Notarial Officer American LegalNet, Inc. www.FormsWorkFlow.com