Free Petition and Affidavit for Expedited Hearing - New Hampshire

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THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us

Court Name: Case Name: Case Number:
(if known)

Guardianship of

PETITION AND AFFIDAVIT FOR EXPEDITED HEARING
(RSA 464-A:4, IV) I/We, , under oath, hereby request an expedited hearing under RSA 464-A:4, IV, and hereby depose and say: In my/our opinion, an expedited hearing for the finding of incapacity and appointment of a guardian of the person and estate, or the person, or estate, is necessary for the following reason(s):

IF THE PETITIONER IS A PHYSICIAN, PLEASE COMPLETE THE FOLLOWING. 1. I am a physician at located at 2. I am the physician for I certify that a copy of this document has been provided to the parties who have filed an appearance for this case or who are otherwise interested parties.
Date Petitioner(s) or Physician Signature (must be signed in presence of notarial officer)

State of This instrument was acknowledged before me on

, County of by
Date Petitioner(s) or Physician Signature of Notarial Officer / Title

My Commission Expires Affix Seal, if any

ORDER Request for expedited hearing is:
Date
NHJB-2169-P (06/04/2008) (formerly AOC-221-003)

Granted
Judge
Page 1 of 1

Denied

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