THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) EX PARTE MOTION Filing Party Name: A. State the facts under oath involving the circumstances which establish that unless the ex parte relief is granted, will, or is likely to, suffer immediate or irreparable harm or injury. (Name) B. What ex parte orders do you want the court to make? NHJB-4014-Se (07/01/2018) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: EX PARTE MOTION Filing Party222s Verification: I verify the truth and accuracy of all facts alleged within this document to the best of my belief and further verify that all facts contained in this document are alleged in good faith. By affixing my signature to this document I acknowledge my understanding that any false statements made in this motion are punishable as perjury which may include a fine or imprisonment or both. For non e-filed cases: I state that on this date I am mailing by U.S. mail, or Email (only when there is a prior agreement of the parties to use this method), or hand delivering a copy of this document to: Other party Other party222s attorney OR For e-filed cases: I state that on this date I am sending a copy of this document as required by the rules of the court. I am electronically sending this document through the court222s electronic filing system to all attorneys and to all other parties who have entered electronic service contacts (email addresses) in this case. I am mailing or hand-delivering copies to all other interested parties. Name of Filer Signature of Filer Date Law Firm, if applicable Bar ID # of attorney Telephone Address E-mail City State Zip code FOR COURT USE ONLY NHJB-4014-Se (07/01/2018) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com