Fill and Sign the Cash Receipt Form

CRIMINAL FORMS 9-312 Supreme Court Approved June 17, 1999 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 by 1 : ________________________________ Date of birth: ________________________________ Social security number 1 : ________________________________ Person paying bond's mailing address 1 : ________________________________ City, state & zip code 1 : ________________________________ PERSON OTHER THAN DEFENDANT PAYING BOND: (check applicable alternative and sign) CRIMINAL FORMS 9-312 Supreme Court Approved June 17, 1999 [ ] I agree [ ] I do not agree that the bond money I have posted may be used to pay any fnes, 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 fnes, 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 CRIMINAL FORMS 9-312 Supreme Court Approved June 17, 1999 USE NOTE 1. Complete if person posting bond is not the defendant. [Approved, efective August 1, 1999.]