THE STATE OF NEW HAMPSHIRE SUPREME COURT http://www.courts.state.nh.us Trial Court Name: Trial Case Name: Trial Case Number: (if known) MOTION TO WAIVE FILING FEE 1. Person requesting that filing fee be waived: 2. Reasons for request to waive filing fee: For the above-stated reasons, I request that the filing fee be waived. Date Signature of appealing party or counsel I certify that a copy of this motion has been sent or delivered to all other parties or their counsel. Date Signature of appealing party or counsel An Affidavit of Assets and Liabilities must be filed with this motion. This form is available at the Supreme Court or on the judicial branch website: http://www.courts.state.nh.us/supreme/forms/index.htm. NHJB-2759-SUP (04/12/2012) American LegalNet, Inc. www.FormsWorkFlow.com