9-312A. Receipt for cash, money order, or cashier’s check.
[For use in the magistrate and municipal courts]
STATE OF NEW MEXICO
[COUNTY OF __________________]
[CITY OF _____________________]
IN THE ________________ COURT
STATE OF NEW MEXICO
[COUNTY OF __________________]
[CITY OF _____________________]
v. No. __________
_______________________________, Defendant.
RECEIPT FOR CASH, MONEY ORDER, OR CASHIER’S CHECK
Defendant information:
Arrest date: _____________________________________
Date of birth: _____________________________________
Mailing address: _____________________________________
City, state & zip code: _____________________________________
Address (physical) (if different
from mailing address): _____________________________________
City, state & zip code: _____________________________________
Telephone number: _____________________________________
(Include current telephone number or contact information in case a refund is due.)
(Fill in only if $10,000 or more is paid.)
Tax ID number or Social Security number of
Defendant: ________________________________
Occupation, profession or business: ________________________________
Payment information:
Date of payment: ________________________________
Amount paid: ________________________________
Number of money order or cashier’s check: ________________________________
Issuer: ________________________________
Payment made by: ________________________________
(print name)
Mailing address of person paying cash,
money order, or cashier’s check if person
paying is not defendant: ________________________________
City, state & zip code: ________________________________
Telephone number: ________________________________
(Include current telephone number or contact information in case a refund is due.)
(Fill in only if $10,000 or more is paid.)
Tax ID number or social security number
of person paying: ________________________________
Occupation, profession or business: ________________________________
PERSON OTHER THAN DEFENDANT PAYING CASH, MONEY ORDER, OR CASHIER’S CHECK:
I understand that the cash I have posted will be used to pay any fines, fees, or costs that the defendant owes if the court has ordered that the defendant may only be released upon the payment of such fines, fees, and costs and that if this is so I will not be entitled to a refund.
If the court has not ordered that the defendant will only be released upon payment of fines, fees, and costs,
[ ] I agree
[ ] I do not agree
that the cash I have posted may be used to pay any fines, fees, or costs that the court may order the defendant to pay after the defendant’s release from custody.
________________________________
Signature of person posting cash
(required)
DEFENDANT: (If the defendant has been arrested on a failure to pay warrant, the defendant’s signature is not required.)
(This alternative may be used only when the defendant has failed to appear, the bench warrant authorizes release on payment of fines and fees, and the person posting the cash has checked the “I agree” box above.)
[ ] I plead guilty to the charges. I ask the court to use the cash for payment of fines, fees, and costs instead of requiring me to appear before the court.
(This alternative may be used only when the bench warrant authorizes release of the defendant on bond, instead of payment of fines and fees.)
[ ] I agree to appear in the ________________ court on _______________, _____ (date) at ________ [a.m.] [p.m.].
______________________________
Signature of defendant
PAYMENT RECEIVED BY:
________________________________
Signature of clerk or bail designee
________________________________
Date
COURT EMPLOYEE RECEIVING PAYMENT:
________________________________
Signature of clerk or bail designee
________________________________
Date
[Approved by Supreme Court Order No. 07-8300-034, effective January 22, 2008; as amended by Supreme Court Order No. 13-8300-037, effective for all cases pending or filed on or after December 31, 2013.]