N.H. Code Admin. R. Adm 1002.06
"Financial statement” means a statement of facts, asserted under oath pursuant to RSA 604-A:2, I, by a defendant regarding the defendant’s income, property, assets, and other financial information necessary to determine a defendant’s eligibility for and ability to pay for appointed counsel. The term includes OCC Form 4, designated by the OCC pursuant to RSA 604-A:2, I, or a court-produced form requiring submission of the same information.
Source. #13050, eff 7-1-20