Form 4-998.1. Cover sheet.

[For use with Rule 1-145 NMRA] STATE OF NEW MEXICO COUNTY OF ________________________ __________________ JUDICIAL DISTRICT In the matter of _________________________, a Protected Person. No. _________________ SEALED – CONFIDENTIAL INFORMATION This filing complies with Rule 1-145 NMRA and contains confidential financial statements in the above referenced matter. Pursuant to Rule 1-145(E)(4)(b), these records shall “be automatically sealed by the court, without the need for a separate court order.” According to Rule 1-145(E)(4)(e), this separate filing shall “not be disclosed to any person or entity other than the State Auditor .... unless authorized by court order. Absent a court order, the confidential filing required under this Paragraph shall not be disclosed to the protected person, the parties to the proceeding, a court-appointed guardian, a court-appointed conservator, or counsel of record and their employees.” A total of ___________ pages, containing confidential financial statements for or on behalf of the protected person, are being submitted to the Court by (select one): □ the court-appointed conservator or □ the court-appointed guardian in the above referenced matter. Date ________________________________ ________________________________ Signature ________________________________ Typed/Printed Name ________________________________ Street or Post Office Address ________________________________ City, State and Zip Code