jay222075Complaint.pdf - For e-Filing only ~0...

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For e-Filing only THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH Court Name: Case Name: Case Number: (if known) SMALL CLAIM COMPLAINT Plaintiff name: Residence address: Mailing address: (if different): Street: Street: City: City: State: Zip code: State: Zip code: Telephone: E-mail: Date of birth: Provide on Confidential Information Sheet If filing on behalf of another individual or a business please see below, otherwise continue to Defendant Information. individual or business in addition to the applicable authorization below.) rd Type of Business/3 Party: (If applicable) Type of Authorization if filing on behalf of individual or business: Power of Attorney Authorization signed by General Partner Defendant name Residence address: Mailing address: (if different): Street: Street: City: City: State: Zip code: State: Zip code: Telephone: on the part of an individual defendant until the Military Statement has been filed.) NHJB-2370-De (03/07/2014) Page 1 of 2 Military Statement Attached
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