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Circuit Court District Division - Forms
Criminal
Form Number
Name of Form
Description
Associated Forms
NHJB-2824-D
(11/25/2013)
Acknowledgment of Rights - Class A Misd Form filled out by a defendant pleading guilty or nolo to a non-DWI related Class A Misdemeanor charge. The form outlines the rights the defendant is waiving by entering a plea and possible sentence elements which may be imposed.  
NHJB-2823-D
(11/25/2013)
Acknowledgment and Waiver of Rights - Class A Misd - DWI Aggravated Form filled out by a defendant pleading guilty or nolo to a charge of DWI Aggravated. The form outlines the rights the defendant is waiving by entering a plea and possible sentence elements which may be imposed.  
NHJB-2472-D
(09/17/2010)
Acknowledgment and Waiver of Rights - Class B Misdemeanor Used when the defendant in a criminal case chooses to plead guilty or no contest to an offense(s).  The waiver used is based upon the charge(s) filed with the court.  
NHJB-2821-D
(11/25/2013)
Acknowledgment and Waiver of Rights - DWI 1st - Class B Misd Form filled out by a defendant pleading guilty or nolo to a charge of DWI First. The form outlines the rights the defendant is waiving by entering a plea and possible sentence elements which may be imposed.  
NHJB-2822-D
(11/25/2013)
Acknowledgment and Waiver of Rights - DWI 2nd - Class A Misd Form filled out by a defendant pleading guilty or nolo to a charge of DWI Second. The form outlines the rights the defendant is waiving by entering a plea and possible sentence elements which may be imposed.  
NHJB-2855-D
(11/25/2013)
Acknowledgment and Waiver of Rights - DWI 3nd - Class A Misd Form filled out by a defendant pleading guilty or nolo to a charge of DWI Third. The form outlines the rights the defendant is waiving by entering a plea and possible sentence elements which may be imposed.  
NHJB-2288-D
(10/31/2006)
Acknowledgment and Waiver of Rights - Violation Used when the defendant in a criminal case chooses to plead guilty or no contest to an offense(s).  The waiver used is based upon the charge(s) filed with the court.  
NHJB-2405-DS
(03/27/2007)
Acknowledgment and Waiver of Rights - Violation of Probation The form is completed by the defendant and counsel when pleading true to a Violation of Probation after having been sentenced to a period of probation following a felony conviction  
NHJB-2859-D
(04/01/2014)
Entry of Not Guilty Plea and Waiver of Arraignment This form is used by a defendant and defendant’s attorney (if any) to indicate the desire to enter a not guilty plea on a Class A or B misdemeanor or violation level offense(s) and waive the right to an arraignment.  
NHJB-2313-DFSSup
(07/01/2013)
Financial Affidavit & Application for Court Appointed Counsel Form is used in criminal or juvenile cases when defendant is requesting a court appointed attorney.  
NHJB-2534-D
(06/09/2008)
Fine Payment Financial Affidavit This form is to be used in criminal cases when a defendant has been sentenced to pay a fine but indicates a present inability to do so. The form is to be fully completed by the defendant on the date of sentencing and prior to leaving the courthouse.  
NHJB-2820-D
(07/25/2013)
Motion to Reduce License Suspension Standard form to be used by a defendant seeking early reinstatement of a license which was suspended as part of a sentence on a DWI conviction. The defendant signs off on having completed all of the individual prerequisites to reinstatement.  
NHJB-2618-DS
(03/25/2013)
Notice of Intent to Seek Class A Misdemeanor Penalties Effective Oct, 2009, certain misdemeanor offenses are presumed to be class B misdemeanors. The State may file to defeat the presumption.  
NHJB-2317-DS
(06/27/2013)
Petition to Annul Record Petition is completed by defendant who is requesting that a criminal record be annulled. How to annul criminal record checklist
NHJB-2860-D
(04/01/2014)
Waiver of Counsel

This form is used by a defendant when the defendant does not want an attorney to represent him/her at arraignment. The judge reviews the form with the defendant and also signs it as confirmation that the defendant understood his/her rights when it was signed.

 

Small Claims

e-filing is now available for small claims cases that started electronically (not in paper) at ALL District Division locations.

Please click here to go to our eforms page.

 

Form Number
Name of Form
Description
Associated Forms
NHJB-2200-DFPS
(06/04/2008)
Affidavit as to Military Service Form completed to show that defaulting party is or is not in military service Instructions
NHJB-2328-D
(12/07/2006)
Affidavit of Assets & Liabilities Filled out and filed by defendants who are ordered back into court in post-judgment civil cases (small claims, civil writs, landlord-tenant judgments) so that the judge can make a determination on the defendant's ability to pay.  
NHJB-2423-DP
(03/01/2010)
Affidavit of Non-Compliance To inform the court and commence contempt proceedings when a defendant in a civil or small claims matter fails to adhere to a payment order issued by the Court. How to collect on judgment in SC, CV & LT case checklist
NHJB-2364-DPS
(11/22/2013)
Motion for Periodic Payments To commence post-judgment collection proceedings when a defendant in a civil matter has failed to pay the court ordered judgment.

How to collect on judgment in SC, CV & LT case checklist

NHJB-2316-DP
(10/25/2010)
Petition to Attach with Notice Form is used by plaintiff to request from the court an attachment against the other party. Instructions

NHJB-2181-DPS
(07/01/2011)

Petition for Ex Parte Attachment Form is used by plaintiff or petitioner to request an attachment against the other party without prior notice to that party.  
Landlord / Tenant
Form Number
Name of Form
Description
Associated Forms
NHJB-2770-D
(08/17/2012)
Affidavit of Damages and Statement of Claim Form used by a landlord seeking to recover damages in a landlord-tenant action which specifies rental arrearage amounts, dates due, any payments, and costs incurred by the landlord for filing and service fees. This form requires an oath be taken  
NHJB-2771-D
(08/17/2012)
Affidavit of Ownership Form used by the person filing a landlord-tenant writ which specifies his or her relationship to the property, thus establishing his or her standing and the court’s jurisdiction over the eviction.  
  Demand For Rent    
  Eviction Notice    
NHJB-2371-DP
(01/02/2014)
Landlord-Tenant Petition RSA 540-A:4 Petition may be filed by either a tenant or landlord seeking relief from a violation of RSA 540-A: 2 or RSA 540-A:3 by the other party (i.e. turning off the utilities or entering the premises without permission). How to stop an action by a landlord or tenant checklist
NHJB-2085-DP
(07/01/2011)
Notice of Intent to Appeal This notice, filed by either party in a Landlord-Tenant Action, informs the court and opposing party of the filing party's intention to appeal an adverse ruling to the Supreme Court.  
Mediation
Form Number
Name of Form
Description
Associated Forms
NHJB-2349-D
(07/01/2011)
Agreement to Mediate / Reporting Form This form is signed by the mediator and parties; Used in District Court Small Claims mediation  
NHJB-2623-D
(01/01/2010)
Civil Writ Agreement to Mediate/Report Form This form is completed reviewed by the mediator with the parties and counsel, if any, at the beginning of the mediation. The form is also used to report the results of the mediation to the Court.  
NHJB-2625-D
(01/01/2010)
Ground Rule for Mandatory Small Claims Mediation This form will be used by the mediator at the beginning of the mediation session to explain the process to the parties and counsel, if any. It will also be used to report the results of the mediation to the Court.  
NHJB-2630-D
(01/01/2010)
Mediator Bill for Services This form is required for all small claim and civil writ cases in which a mediation occurred. Mediators must submit bill for services in order to be paid.  

NHJB-2180-DP
(03/07/2014)

Mediation Report Instructions
NHJB-2089-DFS
(04/12/2012)
Motion for Authorization to Obtain Services other than Counsel Motion submitted by court-appointed counsel requesting authorization for additional services to prepare an adequate defense.  
NHJB-2262-DFS
(12/15/2006)
Statement for Services other than Counsel Statement itemizing the duration and cost of services other than counsel provided to a party by a person or association, after such services have been approved for payment by the court.  
Other
Form Number
Name of Form
Description
Associated Forms
NHJB-2202-DFPS
(10/31/2006)
Agreement Form is completed by parties who are filing an agreement with the court.  
NHJB-2391-DF
(05/06/2008)
Appearance / Withdrawal Form is used by a party or attorney who is filing an appearance or withdrawing their appearance.  
NHJB-2036-DFS
(12/27/2007)
Attorney's Statement Statement submitted by court-appointed counsel, itemizing counsel and paralegal fees, as well as expenses.  
NHJB-2772-DFPSSUP
(10/01/2013)
Audio/Video Notice Form Form is completed by an individual who intends to use audio, video or photography equipment in the courtroom during court proceedings  
NHJB-2409-DFP
(09/16/2011)
Change of Address Notification Form for parties to use to keep court advised of address changes.  
NHJB-2829-D
(08/27/2013)
Complaint and Prayer for Compulsory Mental Examination For use by law enforcement or a petitioner seeking to have a person taken to a hospital emergency room for an emergency mental health examination because the person will not consent to the emergency evaluation and is exhibiting dangerous behaviors towards self or others as a result of serious mental health symptoms.  
NHJB-2656-DFPS
(12/01/2010)
Extra Page for Petitions (or UCCJEA Affidavits) Extra page for petition or UCCJEA affidavits that will not accommodate more than 6 lines of child information (per UCCJEA)  

NHJB-2767-D
(08/10/2012)

Employment Security Wage Garnishment Motion for Periodic Payments Form may be used by the Dept. of Employment Security to initiate a hearing and Order for Payments in an unemployment overcompensation scenario, when the defendant objects to the wage garnishment.  
NHJB-2340-DFS
(03/22/2012)
Guardian Ad Litem Statement Statement submitted by Guardian ad Litem, itemizing fees and expenses.   
NHJB-2826-D
(04/11/2014)
IEA Petition For use by petitioner seeking emergency involuntary admission of a person to a hospital, in New Hampshire, specifically authorized to treat a person’s acute symptoms of mental illness because the person is in such a mental condition as a result of mental illness as to pose a likelihood of danger to self or others .  

NHJB-2332-D
(07/27/2007)

 

Local Land Use Citation - Violation Only Used by a city or town official to cite a defendant's land use violation. The form also allows the defendant to inform the court of his/her plea, except in cases where the citing officer has indicated the defendant must appear in court at a certain time.  
NHJB-2655-D
(07/08/2010)
Local Ordinance Violation Citation / Summons Form filed by a local official with the authority to prosecute an offense under any municipal code, ordinance, bylaw or regulation. The form initiates an action to enforce the violation of a local ordinance pursuant to RSA 31:39-d.  
NHJB-2091-DFPS
(08/20/2014)
Mediation Questionnaire Circuit Court divisions and Superior Court mediators will give the form to the parties after mediation, so they may complete and return to the clerk’s office in a sealed envelope.  
NHJB-2054-DFS
(07/01/2013)
Motion and Affidavit For Return of Deadly Weapons

This form is to be used by the defendant in a civil domestic violence case or a civil stalking case. It is not required to be used in criminal cases. The motion may be filed no sooner than 15 days prior to the expiration of any outstanding civil order but may be filed after the expiration of any such order. It will result in the scheduling of a court hearing.

 
NHJB-2055-DFS
(07/01/2013)
Motion and Affidavit for Return of Firearms

This form is to be used by the defendant in a civil domestic violence case or a civil stalking case. It is not required to be used in criminal cases. The motion may be filed no sooner than 15 days prior to the expiration of any outstanding civil order but may be filed after the expiration of any such order. It will result in the scheduling of a court hearing.

 
NHJB-2201-DFP
(08/29/2014)
Motion: Generic form completed by a person motioning the court for some relief. How to file a motion for... checklist
NHJB-2708-DF
(03/25/2013)
Motion to Close Juvenile Abuse/Neglect Case This form was developed to be used by parties when filing a motion to close an abuse/neglect case.  
NHJB-2756-DFPS
(08/17/2012)
Motion to exceed counsel or GAL fees This form requires the attorney or GAL to submit all information necessary for the judge or master to consider when submitting the request to exceed fee caps to the Administrative Judge for review.   
NHJB-2495-DF
(07/30/2010)
Objection Provides a generic objection form for parties or counsel to use when filing an objection.  
  Records Reseach Request Used by the public to request a records search  
NHJB-2705-DPS
(10/26/2010)
Registration of Foreign Judgment To be filed with the court by judgment creditor who has a judgment from another jurisdiction and is seeking to collect said judgment in NH.  

NHJB-2595-D
(03/25/2013)

 

Request for Court Discharge Form which defendant may file to request a court-ordered discharge of an attachment when a claim has been paid in full but the plaintiff has not provided the discharge within 30 days or there are circumstances requiring an immediate discharge  
NHJB-2589-DFS
(11/25/2013)
Request for Hearing on Temporary Orders This form is used for the defendant to exercise their right pursuant to RSA 173-B:4 to request a sooner Final Hearing on the Temporary Domestic Violence or Stalking Orders.  
NHJB-2233-DF
(07/01/2011)
Right to an Attorney in a Termination of Parental Rights Case, Request for Court-Appointed Attorney or Waiver of Right to an Attorney Form distributed to parent in TPR case explaining right to an attorney. Parent completes form by indicating that s/he intends to hire an attorney or request court-appointed counsel or waive his or her right to an attorney.  
NHJB-2775-DFPS
(03/13/2013)
Subpoena Form is completed by a party or their attorney to compel a person to appear, and/or bring records in their possession, for a court hearing or a deposition. How to subpoena a witness for a court hearing
NHJB-2593-DPS
(10/07/2013)
Trustee Disclosure Parties may use this form when they have received the writ of attachment and trustee process for service from the court. Instructions
NHJB-2660-DFPS
(12/01/2010)
Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Affidavit This form will be used by petitioners and respondents in cases involving custody of minor children when the petition form or response form does not provide spaces or prompts for this information required by UCCJEA. Instructions
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