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Motion For Free Process And Financial Affidavit Form. This is a New Mexico form and can be use in 11th Judicial District Local District Court.
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Tags: Motion For Free Process And Financial Affidavit, New Mexico Local District Court, 11th Judicial District
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
ELEVENTH JUDICIAL DISTRICT COURT
COUNTY OF McKINLEY
Plaintiff(s)
STATE OF NEW MEXICO
-against-
Index No.
:
Calendar No.
:
JUDICIAL SUBPOENA
:
:
,
:
Defendant(s)
:
. . . . . . . . . . . . . . . . . . Plaintiff,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......
-vs-
No.
THE PEOPLE OF THE STATE OF NEW YORK
,
TO
Defendant.
GREETINGS: MOTION FOR FREE PROCESS AND FINANCIAL AFFIDAVIT
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
at the
Court
STATE OF NEW MEXICO )
the Honorable
) ss. located at
County of
in room
, on the
day of
COUNTY OF McKINLEY )
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
I,
, being first duly sworn make the following statements in support
of my Motion for Free Process in the above entitled cause, pursuant to Section 34-6-27(B) N.M.S.A., 1978 (as
amended): Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result 1. your No of people in household:
of
failure to comply.
.
, one of $
2. Witness, Honorable
Entire Family MONTHLY Income (including your spouse’s income):the Justices of the .
Court in
County,
day of
, 20
(a) Sources of employment
(Attorney must sign above and type name below)
I am employed at:
.
and make $
per
My spouse is employed at
and make $
per
.
Attorney(s) for
.
Office and P.O. Address
(b) Public benefits as follows (i.e. AFDC, Food stamps, GA, SSI, Social
Security, etc.)
© Other
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
3.a)
b)
Index No.
Calendar No.
Allowable Expenses: Medical Expenses (not covered by insurance),Court-ordered support
:
JUDICIAL SUBPOENA
Plaintiff(s)
payments/alimony, Child-care payments (e.g. day-care)
-against:
_________________________________________________________________.
:
Other: (payroll garnishments, IRS claims, court ordered attorney fees or other court ordered payments and
funeral expenses not covered by insurance). Must provide :proof.
Defendant(s)
:
. . . . . 4.. . . . . .List. any .assets.you . . . . .and their .values. (i.e. .house, real estate, savings accounts,
.
. . . . . . . . . . . . have . . . . . . . . . . . . . . . . . . .
etc.) ___________________________________________________________
_________________________________________________________________
THE PEOPLE OF THE STATE OF NEW YORK
Total assets.
TO
Movant/Affiant
SUBSCRIBED AND SWORN to before me this ____ day of
, 20
GREETINGS:
.
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County of
Notary Public
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
My Commission expires:
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
[******For clerk use only Honorable
Witness, *************]
Total income: (Monthly income X 12 months)
Court in
County,
day of
Less total expenses (Monthly expenses X 12 months)
Plus total assets:
Net income:
, one of the Justices of the
, 20
$
$
$
$
(Attorney must sign above and type name below)
Indigency table:
HOUSEHOLD SIZE (TOTAL)
1
2
3
4
5
6
------------------------------------------------------------------------------------------------------------------------------------------------------------Attorney(s) for
NET INCOME
$9675
$12,950
$16,225
$19,500
$22,775
$26,050
$29,350
$35,080
7
8
FOR EACH ADDITIONAL ADD: $2,975.00
The applicant is indigent
The applicant is not indigent
Signature of Screening Agent
Office and P.O. Address
Telephone No.:
Facsimile No.:
E-MailDate
Address:
Mobile Tel. No.:
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