New Mexico > Local District Court > 11th Judicial District > San Juan County > Domestic
Application And Order For Free Process - New Mexico
| Application And Order For Free Process Form. This is a New Mexico form and can be used in Domestic San Juan County 11th Judicial District Local District Court . |
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ELEVENTH JUDICIAL DISTRICT COURT STATE OF NEW MEXICO COUNTY OF SAN JUAN __________________________________ Petitioner, vs. Case Number ____________________________________________________________ Respondent. APPLICATION and ORDER FOR FREE PROCESS NAME:___________________________________ AGE: ADDRESS: _________________________________________ (Street, City, State, Zip & Tel.) _________________________________________ _________________________________________ DEPENDENTS: (including myself) No. Of Children:____No. Of Adults:____Total:_____ INCOME: (Before Taxes & Deductions) EXPENSES: List monthly expenses:Employer: __________________________ Rent/Mortgage_____________________City/State/Zip_______________________ Food/Groceries_____________________ Child Care _____________________I receive government aid (check boxes) Food Stamps/AFDC 9 Car Payments_____________________SSI/Disability 9 Utilities/Tel. _____________________Unemployment 9 Medical Bills_____________________VA Benefits 9 Other _____________________TOTAL MONTHLY INCOME:_________ TOTAL MONTHLY EXPENSES:________9 I AM REPRESENTED BY A LAWYER. 9 I AM REPRESENTING MYSELF. ________________________________ STATE OF NEW MEXICO ) Signature of Applicant ) ss. COUNTY OF _________________ ) ACKNOWLEDGED, SUBSCRIBED AND SWORN to before me this _____ day of _____________, 20_____ by ___________________________, the Petitioner. My commission expires: ____________________________________ ____________________ NOTARY PUBLIC <<<<<<<<<********>>>>>>>>>>>>> 2_______ Original Filing Fee Waived _______ Free service of process_______ Post Decree Filing Fee Waived _______ Denied _______ Portion of Filing Fee Waived (must pay mediation fee) IT IS SO ORDERED:_____________________________________ __________ District Judge Date
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