Free Disclosure Statement - Civil Form 3 - New Hampshire

UNITED STATES DISTRICT COURT DISTRICT OF NEW HAMPSHIRE ______________________ Plaintiff(s) v. __________________________ Civil Case No.

______________________ Defendant(s) DISCLOSURE STATEMENT LOCAL RULE 7.5 [This form is to be completed and filed only by parties that are nongovernmental corporations or partnerships. Check the appropriate box(es).] Nongovernmental Corporation

` The filing party, a nongovernmental corporation, identifies the following parent
corporation and any publicly held corporation that owns 10% or more of its stock:

` The filing party identifies the following publicly held corporation with which a
merger agreement with the party exists:

OR

OR Partnership

` The filing party, a partnership, identifies the following nongovernmental
corporate entity that holds an interest in said partnership, the corporate partner's parent corporation, and any publicly held corporation that owns 10% or more of the corporate partner's stock:

` The filing party identifies the following publicly held corporation that has a
merger agreement with the corporate partner:

OR

Nothing to Disclose

` The filing party has none of the above.

Respectfully submitted, [Name of Corporation/Partnership] [Name of Corporation/Partnership] Date:
/s/ [Name of Password Registrant] /s/ [Name of Password Registrant] [Name of Password Registrant] [Name of Password Registrant] [Bar No.] [Bar No.] [Law Firm Name] [Law Firm Name] [Address] [Address] [City, State, Zip Code] [City, State, Zip Code] [Phone: (999) 999-9999] [Phone: (xxx) xxx-xxxx] [E-mail: [email protected]] [E-mail: [email protected]]

-------------------------------------(the following need not be completed if submitted with civil complaint)

CERTIFICATE OF SERVICE I hereby certify that this Disclosure Statement was served on the following persons on this date and in the manner specified herein: Electronically Served Through ECF: [Names of Filing Users]

Conventionally Served: [Name and Address of Non-Filing Users].

Date:

/s/ [Name of Password Registrant] /s/ [Name of Password Registrant] [Name of Password Registrant] [Name of Password Registrant] [Bar No.] [Bar No.] [Law Firm Name] [Law Firm Name] [Address] [Address] [City, State, Zip Code] [City, State, Zip Code] [Phone: (xxx) xxx-xxxx] [Phone: (999) 999-9999] [E-mail: [email protected]] [E-mail: [email protected]]