Form 4-904B. Petition by owner for restitution.

[Sections 47-8-42 and 47-8-46 NMSA 1978; for use only with the Eviction Prevention and Diversion Program] STATE OF NEW MEXICO COUNTY OF _______________ ___________________ COURT _____________________________, Plaintiff(s), v. No. _________ _____________________________, Defendant(s). PETITION BY OWNER FOR RESTITUTION (Uniform Owner-Resident Relations Act) Plaintiff, whose name is ____________________________________________ (include names of all Plaintiffs, if more than one), alleges: 1. Plaintiff is an owner1 lawfully entitled to possession of the premises located at: ___________________________________________________, New Mexico (include street number and street, name of apartment complex, building, and unit number (if any), city, and zip code). 2. Defendant entered into possession of the premises under a rental agreement2 and has breached the terms of the agreement by (check all that apply): [ ] nonpayment of rent; [ ] substantial violation of, or material [ ] damage to premises; non-compliance with, rental or other agreement; or [ ] other (explain facts): _______________________________________________________________ _______________________________________________________________ A copy of any relevant rental agreement with Defendant is attached to this petition. 3. Defendant’s contact information is as follows (check one of the following): [ ] Per Plaintiff’s good faith search, Defendant’s last known contact information is as follows (include for all Defendants, if more than one): Physical address: _________________________________________________ Mailing address (if different) _________________________________________ Phone number with area code: ______________________________________ Email address: ___________________________________________________ [ ] Despite Plaintiff’s good faith search, Plaintiff has been unable to determine Defendant’s current physical, mailing, or email address or phone number, and Plaintiff states that Plaintiff communicates with Defendant as follows (include information for all Defendants, if more than one): ________________________ ______________________________________________________________ 4. On _______________________, ______ (specific date), Plaintiff gave Defendant written notice of (check all that apply): [ ] termination of the rental agreement or residency; and [ ] breach of the rental agreement that Defendant has failed to remedy. This notice was given by (select all delivery methods Plaintiff used): [ ] hand delivery to the Defendant [ ] hand delivery to ______________________________ [ ] mail; (full name); and [ ] posting on exterior door. A copy of any relevant written notice given to Defendant is attached to this Petition. 5. Plaintiff certifies that Plaintiff has provided, or immediately will provide, a copy of the Resource Information Sheet3 designated for use in this particular Court to the Defendant, along with this Petition for Restitution. (check and complete Questions 6 and 7, if applicable) 6. [ ] Defendant owes the Plaintiff the following itemized unpaid rent and/or other charges in the total amount of $ _______________ as of the date of this Petition. (attach an itemized list or insert amounts below for the monthly rent and other charges due through the date of this Petition, as may be evidenced by the rental agreement(s)) Itemized charges: ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ 7. [ ] Plaintiff has received $________________ in total government emergency rental assistance on behalf of the Defendant for the premises listed in Paragraph 1. $___________ addressed back rent, and $____________ was applied as future rent. [ ] Plaintiff is aware of a pending government rental assistance application made on behalf of Defendant for the premises listed in Paragraph 1 by: [ ] Defendant [ ] Plaintiff [ ] Other (specify): ________________________________ 8. Plaintiff holds $_________ as a damage deposit for Defendant under the rental agreement. 9. [ ] Plaintiff requests separate trials on the issues of restitution and damages. 10. Plaintiff requests judgment against Defendant, remedied by (select all remedies that Plaintiff seeks): [ ] 1. Immediate possession of the premises; [ ] 2. Unpaid rent of $_____________, plus future rent calculated as $__________ per _____________ (time period) up to the date of restitution; [ ] 3. Damages as may be determined by the Court;4 [ ] 4. Court costs;5 [ ] 5. Reasonable attorney fees;5 [ ] 6. A civil penalty as provided by law;6 [ ] 7. Other relief as the court may deem reasonable. AFFIRMATION (required, unless signed by an active New Mexico attorney) I SWEAR OR AFFIRM, under penalty of perjury under the laws of the State of New Mexico, that the statements in this petition are true and correct to the best of my knowledge. Dated: _______ _____________________________________________ Plaintiff Signature _____________________________________________ Plaintiff Name (print) _____________________________________________ Plaintiff Address (print) _____________________________________________ City, State and Zip Code (print) _____________________________________________ Plaintiff Telephone Number _____________________________________________ Plaintiff Email Address