UJI 14-994. Failure to notify county sheriff of intent to move from New Mexico to another state, essential elements.1

For you to find the defendant guilty of failing to notify county sheriff of intent to move from New Mexico to another state [as charged in Count _____________]2, the state must prove to your satisfaction beyond a reasonable doubt each of the following elements of the crime: 1. The defendant was convicted of [____________]3; 2. The defendant moved to _____________4 on __________;5 3. Prior to moving, the defendant resided in __________ County; 4. Defendant willfully failed to [notify the county sheriff of his or her intent to move to another state]6 [or] [provide written notice to the county sheriff identifying the state to which defendant intended to move] at least thirty (30) days prior to moving; and 5. This happened in New Mexico between ________, _____ and _____________, ______.