THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Plaintiff/Petitioner v. Defendant/Respondent Case Number: (if known) PETITION / MOTION FOR EX PARTE ATTACHMENT The Plaintiff/Petitioner requests permission to make the following attachments without prior notice to the Defendant/Respondent: Category of Property to be attached (check one) Real Estate Provide address or book & page reference. Attach additional pages if necessary. Name of Defendant/Respondent Other Amount of attachment $ $ $ A. The Plaintiff/Petitioner certifies the following facts to establish a reasonable likelihood that he/she will recover the amount stated above. (Specify facts in detail. Attach additional pages if necessary). B. The Plaintiff/Petitioner asserts that such an attachment is justified on the following grounds: (Specify which of the statutory grounds for making an ex parte attachment applies and detail the facts warranting the application of those grounds. Attach additional pages if necessary). There is substantial danger the property sought to be attached will be damaged, destroyed, concealed, or removed from the state and placed beyond the attachment jurisdiction of the court. There is imminent danger of transfer to a bona fide third party. Other: Date Petitioner/Plaintiff Signature (If petitioner is a corporation or partnership, a duly authorized officer or partner shall sign.) State of This instrument was acknowledged before me on My Commission Expires Affix Seal, if any NHJB-2181-DPS (07/01/2011) , County of by Signature of Notarial Officer / Title Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: PETITION FOR EX PARTE ATTACHMENT V. ORDER Petition / motion to attach is denied. Petition / motion to attach is granted. The Plaintiff/Petitioner is granted permission to make the above attachment(s) and shall complete service on the Defendant/Respondent within days. Petition / motion to attach is granted subject to the following modifications: Date Judge NOTICE TO DEFENDANT/RESPONDENT The court has authorized the above attachment to secure any judgment or decree that the Plaintiff/Petitioner may obtain. You have the right to object in writing, ask for a hearing and request that the attachment be removed. Any objection to this attachment shall be filed in writing within 14 days after service of this notice on you. If you fail to file such a request within the time specified in the order, you will be deemed to have waived your right to a hearing with reference to the attachment, but not with reference to the merits of the Plaintiff/Petitioner's claim. Date Clerk of Court NHJB-2181-DPS (07/01/2011) Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com