Form 9-515A. Misdemeanor crime of domestic violence relationship finding for NICS reporting.

STATE OF NEW MEXICO COUNTY OF ______________________ __________________________ JUDICIAL DISTRICT, _________________________________, Plaintiff v. No. __________ _________________________________, Defendant MISDEMEANOR CRIME OF DOMESTIC VIOLENCE (MCDV) RELATIONSHIP FINDING FOR NICS 1 The Defendant has entered a plea or has been found guilty of the following misdemeanor crime (use a separate form for each charge/victim): [ ] Assault, NMSA 1978, Section 30-3-1; [ ] Assault against a household member, NMSA 1978, Section 30-3-12; [ ] Battery, NMSA 1978, Section 30-3-4; [ ] Battery against a household member, NMSA 1978, Section 30-3-15; [ ] Criminal damage to property of a household member, NMSA 1978, Section 30-3- 18(B); [ ] Aggravated battery, NMSA 1978, Section 30-3-5(B); [ ] Aggravated battery against a household member, NMSA 1978, Section 30-3- 16(B); [ ] Criminal sexual contact, NMSA 1978, Section 30-9-12(D); [ ] Public affray, NMSA 1978, Section 30-20-2; [ ] Stalking (1st offense), NMSA 1978, 30-3A-3; [ ] Attempted 4th degree felony (List the name of the offense): ___________. The Court finds the following upon sentencing: 1. The above conviction involved the use or attempted use of physical force or threatened use of a deadly weapon.2 [ ] Yes [ ] No3 2. The finding of the use or attempted use of physical force or threatened use of a deadly weapon was made by [ ] Admission in plea colloquy, [ ] Stipulation by parties, [ ] Guilty verdict. 3. The name of the victim of this crime is _______________. 4. The relationship between the Defendant and Victim is4: [ ] Defendant is the victim’s current or former spouse; [ ] Defendant shares a child in common/is the co-parent with the victim (biological or adopted children); [ ] Defendant is currently or has cohabitated with the victim as a spouse, parent, or guardian. (serious dating relationship plus cohabitation); [ ] The Defendant is similarly situated as a spouse, co-parent, or co-guardian with the victim; [ ] The Defendant and victim are/were recently dating or involved in an intimate relationship; [ ] The Defendant is the victim’s current or former parent/guardian; [ ] The victim is the Defendant’s present or former parent, parent-in-law or step-parent; [ ] The victim is the Defendant’s grandparent or grandparent-in-law; OR [ ] The relationship between the Defendant and the victim is none of the options above; [ ] There is insufficient, conflicting, or no evidence to determine the relationship between Defendant and the victim. 5. The finding of the relationship was made by [ ] Admission in plea colloquy, [ ] Stipulation by parties, [ ] Guilty verdict, [ ] Judicial Finding5. _________________________________ Judge NOTICE TO DEFENDANT If the relationship box is marked with an “X” in the table below, the Defendant is subject to federal and/or state firearm prohibitions and the Defendant will be reported to the FBI for entry into NICS. If a Defendant is reported to NICS, the Defendant may not possess, receive, ship, transport, or purchase a firearm or ammunition. A Defendant may still be subject to federal and/or state firearm prosecution if the actual relationship between the Defendant and the victim is later established/shown to be different than what is represented at the time this form is completed. Spouse Co-Parents Cohabitated as spouse, parent/guardia n Similarly situated to spouse, parent/guardia Recent Dating/ Intimate Relationship D is Parent or Guardian V is Parent V is Grandparent None Insufficient/No Evidence Assault § 30-3-1(A) X X X X X X Assault Against Household Member § 30-3-12(A)(1) X X X X X X Battery § 30-3-4 X X X X X X Battery Against a Household Member § 30-3-15 X X X X X X X X Aggravated Battery § 30-3-5(B) X X X X X X Aggravated Battery Against Household Member § 30-3-16(B) X X X X X X Criminal Sexual Contact § 30-9-12(D) misdemeanor offense only X X X X X X Public Affray § 30-20-2 X X X X X X Criminal Damage to Property of a Household Member § 30-3-18 X X X X X X X X Stalking (1st offense) § 30-3A-3 X X X X X X X X X X