The trustee disclosure form served upon the trustee in compliance with RSA 512:3 shall include only the following interrogatories and nothing more:
"I. On what date were the trustee writ (including attachment and summons) and trustee disclosure form served upon you?";
"II. What money, rights, goods, chattels, and/or credits belonging to or due defendant did you hold at the time of service?";
"III. Are any of the money, rights, goods, chattels, and/or credits disclosed by you in response to interrogatory II subject to reductions for account fees and/or amounts alleged or determined not to belong to the defendant? If so, please state the amount and the basis."; and
"IV. At this time, are you aware whether the money, rights, goods, chattels, and/or credits disclosed by you in response to interrogatory II are subject to priority claims of other people? If so, please state the amount, the basis for the priority claims, and the claimants."