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____________________________________________
Respondent's signature
Address:
__________________________________________________________
__________________________________________________________
__________________________________________________________
Telephone:
__________________________________________________________
STATE OF NEW MEXICO
)
) ss
COUNTY OF _________________ )
Acknowledged, subscribed and sworn to before me this _____ day of _____________, _____
by _________________, the petitioner.
My commission expires:
________________________________________
_____________________
Notary Public
STATE OF NEW MEXICO
)
) ss
COUNTY OF _________________ )
Acknowledged, subscribed and sworn to before me this _____ day of _____________, _____
by _________________, the respondent.
My commission expires:
_________________________________________
3