New Mexico Forms Library

4-960.3. Affirmation in support of expungement; upon conviction.

[For use with District Court Rule 1-077.1 NMRA]

STATE OF NEW MEXICO

COUNTY OF _________________________

_______________JUDICIAL DISTRICT COURT

In re _________________________________, Petitioner.     No. ____________

AFFIRMATION IN SUPPORT OF EXPUNGEMENT

(Upon Conviction)

I, __________________________, (Petitioner name), am requesting the expungement of records under Section 29-3A-5 (2019) NMSA 1978 (Expungement of Records upon Release upon Conviction), and hereby affirm the following:

1.   [ ] No charge or criminal proceeding is pending against me in any state or federal court in the United States.

OR

[ ] The following charge(s) or criminal proceeding(s) are pending against me in New Mexico state court: ___________________________________________________________________

___________________________________________________________________

[ ] The following charge(s) or criminal proceeding(s) are pending against me in another state court: ___________________________________________________________________

___________________________________________________________________

[ ] The following charge(s) or criminal proceeding(s) are pending against me in federal court: ___________________________________________________________________

___________________________________________________________________

AND

2.   [ ] I have had no criminal convictions against me in the last ten (10) years.

OR

[ ] The most recent criminal conviction against me was: (Provide date of conviction, jurisdiction, case number, offense of conviction, and the date you finished serving your sentence for the conviction)

___________________________________________________________

I, Petitioner, declare under penalty of perjury under the laws of the State of New Mexico that the statements herein are true and correct.

_______________________________  _____________________________________

(Petitioner Signature)                                              (Print Name)

______________________________________________________________________

Street Address                                 City                             State               Zip Code

___________________________________

(Telephone)

[Provisionally adopted by Supreme Court Order No. 21-8300-033, effective for all cases filed or pending on or after January 28, 2022.]