Fill and Sign the Faqs Domestic Abuse under New Mexico Family Violence Form

4-962A. Counter-petition for order of protection from domestic abuse. [Family Violence Protection Act, Sections 40-13-1 to 40-13-8 NMSA 1978.] STATE OF NEW MEXICO COUNTY OF __________________ __________________ JUDICIAL DISTRICT COURT ________________________________________, Petitioner v.No. __________ ________________________________________, Respondent COUNTER-PETITION FOR ORDER OF PROTECTION FROM DOMESTIC ABUSE 1 1. COURT ASSISTANCE REQUEST [ ] We will need an interpreter in __________________ to translate at hearings for [ ] me [ ] the petitioner. [ ] We will need __________________ (describe other request for special help). 2. INFORMATION ABOUT THE PETITIONER (the person I am filing against) A. The petitioner is: [ ] my husband or [ ] my wife [ ] my ex-husband or [ ] my ex-wife [ ] the parent of my [child] [children] [ ] a family member __________________ (describe the family relationship) [ ] a person with whom I have had a continuing personal relationship __________________ (describe the relationship) [ ] a person who has sexually assaulted me [ ] a person who has stalked me B. The petitioner has the following weapons: __________________. 3. [CHILD][CHILDREN] 2 A. List minor [child] [children] of either party. Name Date of Relationship of [Child] [Children] Birth To You To Petitioner _______________ ______________ ______________ ______________ _______________ ______________ ______________ ______________ _______________ ______________ ______________ ______________ _______________ ______________ ______________ ______________ _______________ ______________ ______________ ______________ B. List address and with whom the [child] [children] are currently living. (List each child separately if [child] [children] do not reside with same person. ) ________________________________________________________________________ _______________________________________________________________________________________________________________________________. C. List each address where [child] [children] have lived during the last five (5) years. (List each child separately if [child] [children] did not reside with same person.) ________________________________________________________________________ ________________________________________________________________________________________________________________________________. D. Does anyone else have physical custody of the [child] [children] or claim to have custody or visitation rights? [ ] yes [ ] no If yes, complete the following for the [child] [children] : Child’s name Person claiming rights ________________________ _______________________________ ________________________ _______________________________ 4. OTHER CASES [ ] The following divorce, separation, order of protection, child support, paternity,abuse or neglect cases have been previously filed by me, the petitioner or the state: Type of Case Year Filed Case Number Where Filed (if known) (if known) (city and state) ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ 5. DOMESTIC ABUSE A. The petitioner committed the following act(s) of domestic abuse against me or amember of my household: ( describe in detail what happened to you or to a member of your household and when and where. ) Physical abuse: _______________________________________________ _____________________________________________________________. Threats which caused fear that you or any household member would be injured: ____________________________________________________. Other abuse: _________________________________________________ ____________________________________________________________. Date of abuse: ________________________________________________. Place of abuse: _______________________________________________. B. Others present during the abuse:___________________________________ C. Did drugs or alcohol play a role in the domestic abuse? [ ] yes [ ] no D. Were weapons used during the abuse? [ ] yes [ ] no. If yes, what weapons? ________________________________________ E. Has there been prior domestic abuse? [ ] yes [ ] no. 6. REQUESTS TO THE COURT I REQUEST THAT THE COURT ORDER ( check all that you want): [ ] A. that the petitioner not contact me, not abuse me and that the petitioner stay away from my residence [and] [place of employment] [and] [school]. [ ] B. (1) that the petitioner shall immediately leave [ ] my [ ] our residence at____________________________________________________. [ ] (2) that the petitioner provide me with temporary suitable alternative housing. [ ] (3) ______________________________________ Provide ( address of the place of eviction ). [ ] C. that the petitioner shall not sell, remove, pawn, hide, destroy or damage any property owned by me or the two of us jointly. [ ] D. that law enforcement officers assist me in retrieving my clothing and personal belongings from the residence at ___________________ _________________________________. [ ] E. that I be given temporary custody of the [child] [children] listed in this petition. [ ] F. that until the court hearing: [ ] petitioner shall have the following contact with the [child] [children]:_______________________________________________________________________________________. [ ] petitioner shall have no contact with the [child] [children]: ______________________________________________________________________________________________. [ ] G. that the petitioner shall pay: [ ] support for the [child] [children] [ ] support for me. [ ] H. that the petitioner shall pay me for the damage and medical bills resulting from the abuse. [ ] I. other relief that is necessary to resolve this domestic abuse problem (list or describe what relief is necessary ): ____________________________________________________________ ________________________________________________. 7. INFORMATION ABOUT THE RESPONDENT (ME) (If you do not want the petitioner to know your address and phone number, do not include it on this form. Tell the court clerk that you need to complete two other forms (Forms 4-961A and 4-961B NMRA) for your name and address and request that the clerkplace your address under seal. ) [ ] A. I DO NOT WANT PETITIONER TO KNOW MY ADDRESS NOW OR AFTER THE HEARING FOR THE FINAL ORDER OF PROTECTION. I HAVE COMPLETED FORM 4-961B AND GIVEN IT TO THE COURT CLERK. OR [ ] B. My physical address is: ______________________________ in the [ ] County [ ] Indian Country of __________________, State of New Mexico. My mailing address is: ________________________________________ ( street address) ________________________________________ ( city and zip) My telephone numbers are: Home Work Message ________________ ________________ ________________ 8. NOTICE TO PETITIONER [ ] A. I have not told petitioner that I am filing a counter-petition to ask the court for an order of protection because I believe irreparable harm would result if I told petitioner before coming to court. ( Describe what might happen to you or what you are afraid might happen if the petitioner knew you wereasking for a court order of protection. ) _____________________________________________________ ______________________________________________________. [ ] B. I have told petitioner that I am filing this counter-petition. 9. LOCATION OF PETITIONER A. Petitioner may be found at: ______________________________ ( address) ______________________________ ( city) ______________________________ ( state and zip code) ______________________________ ( if in Indian Country, please name tribe or pueblo ). Petitioner’s: ______________________________ ( date of birth) ______________________________ ( home telephone number) ______________________________ ( work address) ______________________________ ( work telephone number). B. Is petitioner in jail? [ ] yes [ ] no VERIFICATION I, the Respondent/Counter-Petitioner affirm under penalty of perjury under the laws of the State of New Mexico that I am the Respondent/Counter-Petitioner in the above-entitled cause; that I have read the counter-petition for order of protection from domestic abuse; and that the contents of the counter-petition are true and correct to the best of my information and belief. ____________________________ __________________________________ Date Signature of Respondent USE NOTE 1. Respondent should complete all information known by the respondent. 2. This part must be completed if there are children. NMSA 1978, Section 40-10A-209 of the Uniform Child-Custody Jurisdiction Enforcement Act requires the first pleading of every custody action to give information as to the child’s present address, the places where the child has lived within the last five (5) five years and the names and present addresses of the persons with whom the child has lived during that period. If a child lives with you now, but you do not want petitioner to know your address, do not put your current address here, but do fill out Forms 4-961A and 4-961B NMRA. 3. Use Notes 1 and 2 are to be printed on pre-printed forms published for use by pro se respondents. This note and Use Note 4 should not be printed on the form. This form has been approved by the Supreme Court of New Mexico for use in the courts of this state and distributionpursuant to NMSA 1978, Section 40-13-3. Pre-printed pro se forms should include a lined blank page at the end of the form for use by the respondent if the pre-printed form does not include adequate space for a complete answer to a question. 4. NMSA 1978, Section 40-13-3.1(A)(4) provides that a victim in a domestic abuse case shall not be required to pay for “the filing, issuance or service of a petition for an order ofprotection.” [Approved, effective May 1, 2001; as amended, effective February 16, 2004; as amended by Supreme Court Order No. 08-8300-40, effective December 15, 2008; as amended by Supreme Court Order No. 14-8300-023, effective for all pleadings and papers filed on or after December31, 2014.]