9-215

[For use with District Court Rule 5-301,

Magistrate Court Rule 6-203,

Metropolitan Court Rule 7-203 and

Municipal Court Rule 8-202]

STATE OF NEW MEXICO

[COUNTY OF___________________]

[CITY OF_____________________]

__________________________ COURT No. ___________

[STATE OF NEW MEXICO]

[COUNTY OF __________________]

[CITY OF ____________________]

________________________________, Defendant

STATEMENT OF PROBABLE CAUSE

The above defendant has been arrested without a warrant for the following reasons (set forth a plain, concise and definitive statement of facts establishing probable cause):

____________________________________________________________

________________________ (continued on attached sheet)

I SWEAR OR AFFIRM UNDER PENALTY OF PERJURY THAT THE FACTS SET FORTH ABOVE ARE TRUE TO THE BEST OF MY INFORMATION AND BELIEF. I UNDERSTAND THAT IT IS A CRIMINAL OFFENSE SUBJECT TO THE PENALTY OF IMPRIS0NMENT TO MAKE A FALSE STATEMENT UNDER OATH.

________________________ ___________________________

(Date) (Signature)

(This form is to be used only if the defendant was arrested without a warrant and the complaint and any attachments to the complaint do not make a written showing of probable cause.)

[Approved effective September 1, 1990; as amended, effective April 1, 1991; December 1, 1993.]