[6-109, 7-109, 8-108]

STATE OF NEW MEXICO
[COUNTY OF _______________]
[CITY OF _________________]
IN THE __________________ COURT

(STATE OF NEW MEXICO)
(CITY OF ______________________)

v.

________________________________,
(name of person cited)

    I understand that I am charged with the following [motor vehicle] [game and fish] offense or offenses under the law of the (State of New Mexico) (City of __________________): ________________________ (list all offenses charged).

    I understand that I am entitled to personally appear before the court for trial.

    I have received and read a copy of the citation or had the citation read to me. I understand the offense or offenses charged and the fine provided by law.

    After reading and understanding the above, I give up my right to personally appear.

    I enter a plea of [ ] guilty [ ] no contest to each of the offenses charged.

                        ______________________________
                        Signature of person cited

Permission to waive appearance is:

[ ]    granted under the following conditions __________________ (list any conditions).

[ ]    denied.

    1.    This form may only be used to enter a plea of guilty within thirty (30) days after issuance of a penalty assessment misdemeanor citation. Do not use this form if the person cited failed to appear as required or failed to pay the fine, fees and any costs within the time required by law or order of the court. For any other plea of guilty, Form 9-104A may be used to request an audio or audio-visual appearance.

[Approved, effective May 15, 2001.]

Cross-references

See Section 17-2-10.2 NMSA 1978 for game and fish penalty assessment misdemeanors and Section 66-8-117 NMSA 1978 for traffic offenses.