Form 4-960.3. Affirmation in support of expungement; upon conviction.

[For use with District Court Rule 1-077.1 NMRA] STATE OF NEW MEXICO COUNTY OF _________________________ _______________ JUDICIAL DISTRICT COURT In re _________________________________, No. _____________ Petitioner. AFFIRMATION IN SUPPORT OF EXPUNGEMENT (Upon Conviction) I, __________________________, (Petitioner name), am requesting the expungement of records under Section 29-3A-5 (2019) NMSA 1978 (Expungement of Records upon Release upon Conviction), and hereby affirm the following: 1.  No charge or criminal proceeding is pending against me in any state or federal court in the United States. OR  The following charge(s) or criminal proceeding(s) are pending against me in New Mexico state court: ______________________________________________________________ ______________________________________________________________  The following charge(s) or criminal proceeding(s) are pending against me in another state court: ______________________________________________________________ ______________________________________________________________  The following charge(s) or criminal proceeding(s) are pending against me in federal court: ______________________________________________________________ ______________________________________________________________ AND 2.  I have had no criminal convictions against me in the last ten (10) years. OR  The most recent criminal conviction against me was: (Provide date of conviction, jurisdiction, case number, offense of conviction, and the date you finished serving your sentence for the conviction) ______________________________________________________________ ______________________________________________________________ I, Petitioner, declare under penalty of perjury under the laws of the State of New Mexico that the statements herein are true and correct. _______________________________ (Petitioner Signature) ________________________________ (Print Name) _____________________________________________________________________ Street Address City State Zip Code ___________________________________ (Telephone) [Provisionally adopted by Supreme Court Order No. 21-8300-033, effective for all cases pending or filed on or after January 28, 2022; provisionally adopted form approved as amended by Supreme Court Order No. S-1-RCR-2024-00099, effective for all cases pending or filed on or after December 31, 2025.]