STATE OF NEW MEXICO COUNTY OF BERNALILLO SECOND JUDICIAL DISTRICT , Petitioner, v. No. , Respondent. CERTIFICATE AS TO THE STATE OF THE RECORD (domestic relations actions)1 I, Clerk of the District Court of this Judicial District in this County, New Mexico, pursuant to the Affidavit as to Respondent222s Failure to Plead or Otherwise Defend on file herein, certify as follows: (1) The Petition for Dissolution of Marriage was filed on . (2) Petitioner was served as follows (choose and complete one): [ ] As shown by the Affidavit of Service filed on , Respondent was personally served on . (Or) [ ] As shown by the Affidavit of Publication filed on , Respondent was served by publication. (3) Respondent has not filed an answer, motion, or otherwise responded, and more than thirty (30) days have passed since Respondent was served with the Summons and Petition for Dissolution of Marriage. WHEREFORE, I,, hereby certify Respondent222s default. Clerk of the District Court By: Deputy Clerk Rev. 12/31/14 American LegalNet, Inc. www.FormsWorkFlow.com DO NOT FILE THIS PAGE: FOR PARTY USE ONLY USE NOTE 1. This form may be used anywhere in this state by the clerk of the court to certify a default in a domestic relations action. [Approved by Supreme Court Order No. 13-8300-010, effective for all pleadings and papers filed on or after May 31, 2013, in all cases pending or filed on or after May 31, 2013; as amended by Supreme Court Order No. 14-8300-011, effective for all pleadings and papers filed on or after December 31, 2014, in all cases filed or pending on or after December 31, 2014.] Rev. 12/31/14 American LegalNet, Inc. www.FormsWorkFlow.com