THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: MOTION FOR PERIODIC PAYMENTS (P ursuant to RSA 524:6 - a) Judgment not having been satisfied in full, the Filing Party in the above-entitled matter requests that the Court issue Summons requiring the Other Party to appear in court so that an order for periodic payments may be considered. Total Amount of Judgment $ Filing Fee $ Total Paid to Date $ Balance Due $ Instructions to Filing Party: You are required to formally serve the Other Party with the Summons which will contain the date of the hearing you requested. Select one of the options below. The court will send you the necessary paperwork based on your selection. I request that a Summons be issued to me for service by certified mail, restricted delivery, return receipt requested. I understand that I will be responsible for completing the certified mail process and for any certified mail expenses. I request that a Summons be issued to me for personal service by a Sheriff. I understand that I will be responsible for delivery of the Summons to the Sheriff and for any personal service expenses. 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: or 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. NHJB-4001-Se (07/01/2018) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: MOTION FOR PERIODIC PAYMENTS Name of Filer Signature of Filer Date Law Firm, if applicable Bar ID # of attorney Telephone Address E-mail City State Zip code NHJB-4001-Se (07/01/2018) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com