THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) WAIVER OF EXTRADITION DEFENDANT: CHARGE: I am a Defendant in County Superior Court, as noted above, and I wish to waive my rights to formal extradition proceedings. If I am in another state, the State of New Hampshire may make formal demand for my return to New Hampshire to face the above charges. A Governor's Warrant would be issued and served on me and, after an extradition hearing, I could be returned to New Hampshire. I voluntarily, knowingly and intelligently waive my rights to a Governor's Warrant and a formal hearing, if I am in another state. I CONSENT TO RETURN VOLUNTARILY AND WITHOUT HEARING OR OTHER FORMALITY TO NEW HAMPSHIRE TO FACE THE ABOVE CHARGES. This waiver does not limit the authority or duty of the State of New Hampshire to obtain my return from another state by any legal means. Date Defendant Witness I have explained the provisions of RSA 612 and this Waiver of Extradition to my client and believe his/her waiver is made voluntarily, knowingly and intelligently. Date Defense Counsel NHJB-2310-S (10/31/2006) Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com