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THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us Name: Case Name: Case Number: SCN: (if known) Arrest warrant issued for: D.O.B.: Address: Personal Identifiers on File: Gender: M F Height: Weight: (Provide in Criminal Cases Only) Race: Hair: Eyes: THE ABOVE IDENTIFIERS ARE FOR LAW ENFORCEMENT USE ONLY An arrest warrant for the above-named individual has been issued for the following reason(s): Non-appearance in Court for a(n) on Violation of Condition(s) Violation of Court Order Failure to Report for Sentence Violation of Probation filed Other (specify reason for warrant): The following bail order is made: The above-named individual is held without bail or bond. Bail will be set by the Court upon apprehension. Bail is set in the amount of $ Cash Cash/Surety Personal Recognizance The shall be released upon payment of $ , which SHALL MAY be forfeited without a further hearing to: Office of Cost Containment Department of Court Judgment Creditor The Defendant posted recognizance and was notified to appear. A $50.00 default fee is imposed. Should the defendant fail to appear within 45 days of today's date, bail previously posted will be forfeited to the State. If corporate surety is forfeited, the Court shall notify the NH Bureau of Securities Regulation. Other bail conditions:

SO ORDERED.

******************************************************************************************************************* The of any county, his/her deputies or any officer authorized by law is ordered to arrest the above named individual and bring him/her before the Superior Court immediately if bail not set. Bail is set as indicated above.

Date Clerk of Court Order Expires on (Civil Cases ONLY – Date to be entered by Court) ****************************************************************************************************************************** SHERIFF'S RETURN In accordance with this order, has been arrested and I have caused this return to be filed with the Superior Court.

Date Sheriff

NHJB-2720-Se (08/06/2019)