9-312

[For use in the magistrate, metropolitan and municipal courts]

STATE OF NEW MEXICO

[COUNTY OF___________________]

[CITY OF_____________________]

__________________________ COURT                              No. ___________

[STATE OF NEW MEXICO]

[COUNTY OF __________________]

[CITY OF ____________________]

v.

________________________________, Defendant

CASH BOND RECEIPT

AND

CONVERSION AFTER ARREST ON BENCH WARRANT

Defendant information:

Arrest date:                             ________________________________

Date of birth:              ________________________________

Social security number:          ________________________________

Mailing address:                     ________________________________

City, state & zip code:            ________________________________

Address (physical):                 ________________________________

City, state & zip code:            ________________________________

Bond information:

Date bond posted:                   ________________________________

Amount posted:                                  ________________________________

Bond posted by¹:                    ________________________________

Date of birth:                          ________________________________

Social security number¹:        ________________________________

Person paying bond's

  mailing address¹:                   ________________________________

City, state & zip code¹:          ________________________________

PERSON OTHER THAN DEFENDANT PAYING BOND:

(check applicable alternative and sign)

[ ]        I agree

[ ]        I do not agree

that the bond money I have posted may be used to pay any fines, fees or costs that the court may order the defendant to pay after the defendant's release from custody.

                                                            __________________________________

                                                            Signature of person posting bond

DEFENDANT: (check applicable alternative and sign)

[ ]        I agree to appear in the ________________ court on _______________, _____ (date) at ________ [a.m.] [p.m.]

(This alternative may be used only

when authorized by the bench warrant and

by the person posting the bond.)

[ ]        I plead guilty to the charges. I ask the court to use the bond for payment of fines, fees and costs instead of requiring me to appear before the court.

                                                            __________________________________

                                                            Signature of defendant

BOND RECEIVED BY:

                                                            ___________________________________

                                                            Signature of clerk or bail designee

                                                            ___________________________________

                                                            Title

____________________________________

                                                            Date

COURT EMPLOYEE RECEIVING PAYMENT:

                                                            ___________________________________

                                                            Signature

                                                            ___________________________________

                                                            Title

____________________________________

                                                            Date

USE NOTE

            1.         Complete if person posting bond is not the defendant.

[Approved, effective August 1, 1999.]