Fill and Sign the State V Powell 1992 New Mexico Court of Appeals Form

CIVIL FORM 4-904Supreme Court ApprovedJanuary 19, 20054-904[Sections 47-8-42 and 47-8-46 NMSA 1978]STATE OF NEW MEXICOCOUNTY OF __________________________________ COURT No. __________ __________________________________, Plaintiffv.__________________________________, Defendant PETITION BY OWNER FOR RESTITUTION (Uniform Owner-Resident Relations Act) The plaintiff alleges:1.Plaintiff is lawfully entitled to possession of the premises located at1 :__________________________________________________________________________________________________________________________________________________________, New Mexico _______.2.Defendant entered into possession of the premises under a rental agreement and has breached the terms of the agreement, as follows:_______________________________________________________________________________________________________________________.3.Plaintiff gave written notice of[ ] termination[ ] breach of the rental agreementto defendant on _________________, ____ (date), and defendant has failed to remedy the breach.A copy of the written notice is attached as Exhibit A.(check and complete if applicable)[ ] 4. Defendant is indebted to plaintiff in the sum of $_____________ for unpaid rent, plus $______________ rent per day to date of restitution, plus damages as determined by the court.[ ] 5. Plaintiff holds $___________ of defendant as a damage deposit under the rental agreement.[ ] 6. Plaintiff requests separate trials on the issues of restitution and CIVIL FORM 4-904Supreme Court ApprovedJanuary 19, 2005damages.Plaintiff requests judgment against defendant, as follows:1.Immediate possession of the premises;2.Unpaid rent of $_____________, plus $__________ per day to date of restitution;3. Damages as may be determined by the court;4.Costs of this action;5.Reasonable attorneys fees;6.A civil penalty as provided by law;7.Such other relief as the court may deem reasonable.Dated: ____________________________________________________Signed________________________________Name (print)________________________________Address (print)________________________________ City, state and zip code (print)________________________________Telephone number USE NOTES 1.If the leased premises is an apartment, include the name of the apartments and the apartment number.2. The owner must bring a copy of any written rental agreement to court for the hearing on the petition for restitution.[As amended, effective March 21, 2005.]