N.H. Admin. Code § Adm 1003.02 - Information Required on a Financial Statement

A financial statement shall contain the following information about the defendant:

(a) His or her:

(1) Name;

(2) Address;

(3) Telephone number;

(4) Date of birth; and

(5) Age;

(b) His or her marital status, whether:

(1) Single;

(2) Married;

(3) Divorced;

(4) Separated; or

(5) Widowed;

(c) With respect to dependents personally supported by the defendant:

(1) Their names;

(2) Their addresses if different from that of the defendant;

(3) Their relationship to the defendant; and

(4) Their ages;

(d) For both the defendant and a spouse of the defendant, the amounts of the following kinds of funds available to each of them, individually:

(1) Cash on hand;

(2) Money in checking accounts;

(3) Money in savings accounts;

(4) Funds in stocks, bonds, trusts, certificates of deposit and similar investments; and

(5) The total sum of the amounts provided for (1) through (4), above;

(e) For both the defendant and a spouse of the defendant, the amounts of the following received by each of them, individually, weekly, and monthly:

(1) Take home pay in the form of wages or salary;

(2) Alimony or maintenance received;

(3) Child support received; and

(4) The total sum of the amounts provided for (1) through (3), above;

(f) For the defendant and a spouse of the defendant, the following employment information:

(1) Name of employer;

(2) Address of employer; and

(3) Whether employment is full time, part time or seasonal;

(g) The defendant's monthly housing costs in the form of:

(1) Monthly rent or mortgage;

(2) Utilities; and

(3) The total sum of the costs provided for (1) and (2), above;

(h) The defendant's monthly loan payments, including the following information about such payments:

(1) The payee(s);

(2) The purpose(s) of the loan(s) being repaid;

(3) The balance(s) due on the loan(s);

(4) The amount(s) of the monthly payment(s); and

(5) The total of all monthly loan payments;

(i) Additional monthly payments, such as alimony, child care and child support, including:

(1) The payee(s);

(2) The purpose(s) of the payment(s);

(3) The sum(s) still owed;

(4) The amount(s) of the monthly payment(s); and

(5) The total of all such monthly payments; and

(j) With respect to the defendant's ownership of real estate and personal property:

(1) Whether the defendant owns a house or other real estate, and if so:

a. Identification of the real estate;

b. The market value of such real estate;

c. The identity of the mortgage holder on such real estate, if applicable; and

d. The amount of the mortgage on such real estate, if applicable; and

(2) Whether the defendant has, within the last 6 months, sold or transferred real estate or personal property worth $200.00 or more, and if so:

a. Identification of such real estate or property;

b. The identity of the transferee of such real estate or property;

c. The value of such real estate or property; and

d. The amount received for such real estate or property.

Notes

N.H. Admin. Code § Adm 1003.02

(See Revision Note at chapter heading for Adm 1000) #8697, eff 8-3-06; ss by #9149, eff 5-1-08

Amended byVolume XXXIV Number 50, Filed December 11, 2014, Proposed by #10728, Effective 10/25/2014, Expires10/25/2024. Amended by Volume XL Number 24, Filed June 11, 2020, Proposed by #13050, Effective 7/1/2020, Expires 7/1/2030