NHJB-3062-DP (07/26/2021) Page 1 of 1
Please enter my appearance as:
Counsel/Representative for
I will represent myself (pro se).
If the box in Paragraph 2 of the Landlord and Tenant Writ is checked, indicating that the landlord
is requesting the award of money damages for unpaid rent, the tenant has a right to file a Claim or
Counterclaim for money damages. By checking the box on this form and attaching a Tenant’s Claim
or Counterclaim Against Landlord form (NHJB-3059-D), the tenant is making that claim.
I certify that on this date I provided a copy of this document to (other party) or to
(other party’s attorney) by: Hand-delivery OR US Mail OR
E-mail (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order).
Date Signature
Printed Name
Mailing Address
Telephone NH Bar ID #
Email Address
You may apply for rental assistance at your town/city welfare office if you are a qualified residential
tenant. Additionally, tenants and landlords impacted by COVID-19 may be eligible for financial
assistance with rent and utility costs. Learn more and apply at CAPNH.org or call 2-1-1. NOTE: Even
if you apply for rental assistance, you must attend the hearing in this matter. Failure to appear
may result in the Court ordering you to be evicted without hearing from you.
THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us
Court Name:
Case Name:
Case Number:
(if known)
APPEARANCE
For use in Landlord and Tenant Cases
