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									                  NEW MEXICO BAR LICENSURE APPLICATION
Pursuant to the rules which are applicable, I hereby apply for admission to practice law in all courts of
the State of New Mexico.

Permission is respectfully requested to take the bar examination to be held in Albuquerque, New Mexico
on the following date:
               (month)                      (year))



Application fee in the sum of                                 is enclosed herewith.

Material facts in support of this petition are shown by my answers to the following questions, and
attachments thereto

                                INSTRUCTIONS TO THE APPLICANT

All statements are to be based on your own knowledge, unless the statement is expressly qualified to
show the source of your information. Answer all questions completely and make your answers as
specific as possible. If a question is not applicable to you, you must so state. Be sure the cursor is
inside the underline code so your answer will be underlined; tab while in the last cell of a table to
add a new table row. If you are using a typewriter to prepare this application and the space for an answer
is insufficient, complete your answer on separate, attached sheets and identify them as an addendum to
your application. If information becomes available subsequent to the date of this application, you must
supplement the application prior to your admission.

                        APPLICANT’S QUESTIONNAIRE AND AFFIDAVIT

1. State:

    (a) Full Name:                                                  Social Security No.:

    (b) Have you ever been known by any other name or Surname?                   Yes           No

        If so, state all names used and the places and times thereof. If a married woman, give maiden
        name.
                  Name Used                           Dates                            Place




    (c) Date of Birth                       Birthplace (city & state)                          Age

    (d) Are you a citizen of the United States?                                  Yes           No




                                                     Page 1 of 12
        If citizenship is other than by birth in the United States, state the basis of the citizenship and
        exhibit proof.
                          Basis of Citizenship                                     Proof



        If naturalized, state the date and name and location of the Court with the Number of Certificate
        and the Petition Number.
         Naturalization Date         Court Name         Court Location      Certificate No.        Petition No.



2. State every residence you have had for the last five years:
                Street Address                           City & State               From                 To




    Present mailing address:
                                    Street/PO Box              City               State            Zip Code

    Telephone Numbers:
                                                 Home                                     Office

    E-mail:

    Domicile:
                   Street/PO Box                               City               State            Zip Code

3. Parents (if living):
                              Name                             Address                        Occupation

    Father:

    Mother:

4. State all schools attended and indicate information requested below:

    (a) High School:
                                Name                                             Location



    (b) College or University other than law study:
                                                                                  Attended
                 Name                       Location                     From                       To




                                                          Page 2 of 12
                                                                             Attended
                  Name                  Location                    From                     To




        Degree:                       School:                                     Date:

    (c) Law Study:
                                                                              Day or         Attended
             Law School                   Location (city & state)            Evening      From      To




        Degree:                       School:                                     Date:

5. Make a complete statement of the general character of your practice of law since first being admitted
   to practice in any jurisdiction. Include temporary or part time work. For each employment or period
   of private practice, state:
   (1) The periods during which you were employed as an attorney or engaged in private practice, with
       the exact dates.
   (2) The exact addresses of the offices or places at which you were so employed or engaged and the
       complete names and present addresses of all such former employers, including the name and
       current address of your supervising attorney or the managing partner, if any, and specify the
       relationship. (If room number of office is known, this should be given. If you shared office space
       with other lawyers or business firms, please so state and give their full names and present
       addresses.) If you maintained a practice as a sole practitioner, please provide the name and
       address of a non-relative, such as your accountant or landlord, who can verify this
       information.
   (3) The nature and extent of your duties and/or practice.
   (4) The reason for the termination of each employment or period of private practice.

     From         To       Employer             Address             Duties   Comments       Reasons Left




6. Make a complete statement of all employment you have had, or business or occupations in which you
   have been engaged on your own account, since you were 18 years of age or for the last 10 years,
   whichever is shorter, other than as set forth under questions 5 and 7. Include temporary or part time
   work. State as to each employment, business or other occupation:
   (1) The periods during which you were so employed or engaged, with the exact dates (month and
       year).
   (2) The exact addresses of the offices or places at which you were so employed or engaged and the
       complete names and present addresses of all such former employers, partners or associates in
       business, if any, and specify relationship.
   (3) The position held by you.
   (4) The reason for the termination of each employment, business, or other occupation.



                                                    Page 3 of 12
     From        To          Employer          Address         Position/Duties       Comments    Reasons Left




7. State any present employment, not listed under question 5 or 6 above, including beginning date, name
   and address of employer, name and title of immediate superior, and the nature of your
   responsibilities. If self-employed, state name and nature of business, office address and names of
   associates, if any. If you are self-employed, you must provide the name and address of a non-relative
   that can verify this self-employment.
      Date
     Started           Employer           Address         Position/Duties         Supervisor     Comments




8. Give a detailed statement regarding any service in the Armed Forces, including dates of active
   service, rank, serial number, locations, last commanding officer, and your last, complete service
   address.
      Dates of                                                                         Last          Last
       Active          Branch of                      Serial                        Commanding      Service
      Service           Service         Rank         Number           Locations       Officer       Address




    If separated from service, state nature of separation, and if other than honorable, specify type thereof
    and circumstances surrounding your release. Give full particulars of any formal complaints or
    disciplinary proceedings against you.




9. (a) Have you ever held a license, other than as an attorney-at-law, the
       procurement of which required proof of good character?                         Yes          No

        As to each license, state the date it was granted, and the name and address of the issuing
        authority:
                      License Granted               Date Granted         Name & Address of Issuing Authority




                                                       Page 4 of 12
                  License Granted                Date Granted           Name & Address of Issuing Authority



    (b) State every other application presented and examination taken by you for a license granted by a
        state or for an official position, the procurement of which required proof of good character,
        except applications for admission to the bar. For each application, state the date, the name and
        address of the authority to whom it was addressed and the disposition made with the reasons
        therefore; for each examination, state the date and whether successful or unsuccessful.
           Application                           Name of                    Address of          Disposition/
         Or Examination         Date         Granting Authority          Granting Authority    Exam Outcome




10. State every application presented and examination taken by you for admission to the bar of any
    jurisdiction other than New Mexico, including applications for reinstatement and any application
    subsequently withdrawn. For each application, state the date, the name and address of the authority to
    whom it was addressed and the disposition made with the reasons therefore; for each examination,
    state the date and whether successful or unsuccessful.
       Bar Application                           Name of                   Address of           Disposition/
       Or Examination           Date         Granting Authority         Granting Authority     Exam Outcome




11. Name all jurisdictions and courts in which you have been admitted to practice law with the dates of
    admission.
                                    Jurisdiction/Court                                        Date Admitted




12. Have you been entitled to practice in each of the locations specified under
    question 11 and before each court continuously from the date you first
    became entitled until the date thereon?                                     Yes                No

    If not, state the dates during which you have not been so entitled, the nature of the disqualification,
    the facts, and the name and address of the person or body in possession of the record thereof.
         Dates of                Nature of                                           Name & Address of
      Disqualification        Disqualification              Relevant Facts       Authority Possessing Record




                                                         Page 5 of 12
         Dates of                  Nature of                                         Name & Address of
      Disqualification          Disqualification          Relevant Facts         Authority Possessing Record




13. Have you ever been disbarred, suspended from practice, reprimanded,
    censured or otherwise disciplined or disqualified as an attorney or a
    member of any profession or organization, or holder of any office, public
    or private; or have any complaints or charges, formal or informal, ever
    been made or filed or proceedings instituted against you?                 Yes                  No

    If so, state the dates, the facts, the disposition of the matter, and the name and address of the authority
    in possession of the record thereof.
         Dates of              Relevant Facts of           Disposition of            Name & Address of
        the Matter                the Matter                 the Matter          Authority Possessing Record




14. If you have been previously admitted to the bar, state the exact names and addresses of courts before
    which your former practice of law was chiefly conducted.
                             Court                                              Address




15. Have you ever held any judicial office?                                         Yes            No

    If so, state offices held, when, where, and if terminated the reasons therefore.
      Judicial Office Held           Dates                      Place                     Reason Terminated




16. (a) Have you, in your individual capacity, ever been a party to or had
        claims or any interest in any civil proceeding?                             Yes            No

    (b) Have you ever been charged with, arrested, or questioned
        regarding the violation of any law, including juvenile offenses?            Yes            No

    (c) Have you ever been charged with fraud, formally or informally,
        in any legal proceeding, civil or criminal, or in bankruptcy?               Yes            No

    (d) Have you ever been adjudicated a bankrupt, or has a petition in
        bankruptcy been filed at any time by you or against you, either
        alone or in association with others? Have you ever been brought
        in as a party to any proceedings in a bankruptcy court; or have             Yes            No



                                                       Page 6 of 12
       you ever been sued or threatened with suit by the receiver,
       trustee, or other authority of any bankrupt estate, for unlawful
       preference, conspiracy to conceal assets, or any fraud or offense,
       whether punishable by criminal law or not?

   Give full details for (a), (b), (c) and (d), including dates, exact name and location of court, if any, case
   number, references to court records, if any, the facts, the disposition of the matter; if no court records
   are available, to the best of your ability give the names and addresses of all persons involved,
   including counsel. (Include all such incidents no matter how minor the infraction or whether guilty or
   not, except for minor violations which did not involve a court appearance.)
                                                    Court
                   Court Name                      Records            Facts of    Disposition     Information/
       Dates       & Location       Case No       References         the Matter   of the Matter    Comments




17. (a) Were you ever dropped, suspended or expelled from school or
        college?                                                                    Yes            No

       If so, state facts fully.




   (b) Have you ever been discharged or have you ever resigned from
       any employment after being told that your conduct or work was
       not satisfactory?                                                            Yes            No

       If so, state facts fully.




18. Do you have any condition or impairment that currently impairs your
    ability to practice law?                                                        Yes            No

   If yes, please provide the specifics, including dates, the name(s) and the address(es) of treating
   physician(s) or mental health counselor(s).
               Dates                    Name and Address of Physician or Mental Health Counselor




   “Medical condition or impairment” means any physiological, mental or psychological condition,
   impairment or disorder, including drug addiction and alcoholism.
   “Ability to Practice Law” is to be construed to include the following:
   (a) The cognitive capacity to successfully undertake fundamental lawyering skills, such as problem
       solving, legal analysis and reasoning, legal research, factual investigation, organization and
       management of legal work, making appropriate, reasoned legal judgments, and recognizing and
       resolving ethical dilemmas; and



                                                      Page 7 of 12
   (b) The ability to communicate clearly and effectively legal judgments and legal information to
       clients, other attorneys, judicial and regulatory authorities, with or without the use of aids or
       devices; and
   (c) The capability to perform legal tasks in a timely manner.
   The Board understands that mental health counseling or treatment is a normal part of many persons’
   lives and such counseling or treatment does not of itself disqualify an applicant from the practice of
   law. Furthermore, the Board does not wish to pry into the private affairs of applicants; however, the
   Board is obligated by the Supreme Court of New Mexico’s rules governing admission to the Bar
   (SCRA 1986 §§ 15-103; 15-301; 15-401) to determine whether an applicant is physically and
   mentally fit to practice law, and therefore must inquire into such matters to the extent necessary to
   make such determination. The Board is not seeking disclosure of counseling or treatment for a
   dramatic or upsetting event such as death, break-up of a relationship or a personal assault, even if
   such event does affect the applicant’s ability to practice law for a limited time.

19. Have you ever been involved in, reprimanded for or disciplined by an employer or educational
institution for misconduct, including:
   (a) acts of dishonesty, fraud or deceit;                                       Yes           No
   (b) lying or misrepresentation on an application or resume;                    Yes           No
   (c) academic misconduct, including such acts as cheating;                      Yes           No
   (d) misconduct involving student activities;                                   Yes           No
   (e) theft;                                                                     Yes           No
   (f) excessive absences;                                                        Yes           No
   (g) failure to complete assignments in a timely manner;                        Yes           No
   (h) actions in disregard to the health, safety and welfare of others;          Yes           No
   (i) discrimination or harassment based upon sex, religion, age,
       disability, race or national or ethnic origin;                             Yes           No
   (j) neglect of financial responsibilities;                                     Yes           No
   (k) conduct related to the use of alcohol or any other drug in the last
       10 years?                                                                  Yes           No

   If yes to any of the above, please provide the specifics, including date of the action, by whom taken,
   the name and address of the employment supervisor or academic advisor involved, if applicable, and
   any person involved in the investigation of your conduct.
       Date of      Relevant Facts of         What Action Taken      Name & Address of    Name & Address
     the Action        the Matter                By Whom             Supervisor/Advisor    of Investigator




20. Have you ever been terminated or granted a leave of absence by an
    employer or withdrawn from an educational institution?                        Yes           No

   If yes, please provide the specifics, including date of the action, by whom taken, and the name and
   address of the employee’s supervisor or academic advisor involved




                                                      Page 8 of 12
       Date of             Relevant Facts of               What Action Taken           Name & Address of
     the Action               the Matter                      By Whom                  Supervisor/Advisor




21. Are you currently engaged in the illegal use of drugs?                       Yes            No

    “Illegal Use of Drugs” means the use of controlled substances obtained illegally as well as the use of
    controlled substances which are not obtained pursuant to a valid prescription or taken in accordance
    with the directions of a licensed health car practitioner.

    “Currently” does not mean on the day of, or even the weeks or months, preceding the completion of
    this application. Rather, it means recently enough so that the condition or impairment may have an
    ongoing impact

    You have a right to elect not to answer those portions of the above questions which inquire as to the
    illegal use of controlled substances or activity you have reasonable cause to believe that answering
    may expose you to the possibility of criminal prosecution. In that event, you may assert the Fifth
    Amendment privilege against self-incrimination. Any claim of the Fifth Amendment privilege must
    be made in good faith. If you choose to assert the Fifth Amendment privilege, you must do so in
    writing. You must fully respond to all other questions on this application. Your application for
    licensure will be processed if you claim the Fifth Amendment privilege against self-incrimination.

22. (a) Are there any unsatisfied judgments against you?                         Yes            No

    (b) Have you any debts 90 days past due?                                     Yes            No

    (c) Have you ever been more than 30 days past due in the payment of
        any child support obligation or alimony (spousal maintenance)
        obligation?                                                              Yes            No

    If yes to (a), (b) or (c), list details, give names and addresses of creditors, amounts, dates and the
    nature of debts of judgments, and the reason for nonpayment.
        Names &
      Addresses of                               Dates of Debt        Nature of Debt         Reason for
       Creditors             Amount(s)            Judgments             Judgment            Nonpayment




23. (a) Are you now or have you ever been married?                               Yes            No

        If so, give date and place of each marriage and full name of your spouse prior to that marriage.
              Date of                           Place of                         Full Name of Spouse
              Marriage                          Marriage                         Prior to the Marriage




                                                     Page 9 of 12
               Date of                             Place of                      Full Name of Spouse
               Marriage                            Marriage                      Prior to the Marriage




    (b) State whether or not you have ever been divorced.                        Yes           No

        If so, give the name of the divorced spouse, the exact name and address of the court, case number,
        date, ground(s) of divorce, by whom suit was brought, together with names and addresses of
        counsel.
                                                                                  Name of
            Name of             Name &                                          Person Who      Names &
            Divorced            Address     Case                   Ground(s)      Brought      Addresses
            Spouse              of Court     No.         Date      of Divorce     the Suit     of Counsel




    (c) If a divorce suit is pending or a marriage has been annulled, give particulars similar to those
        requested under (b) above.
                                                                                 Name of
                                Name &                                           Person         Names &
             Name of            Address     Case                   Ground(s)     Bringing      Addresses
             Spouse             of Court     No.         Date      of Divorce    the Suit      of Counsel




24. Is there any other incident in your career, not hereinbefore referred to,
    having a bearing upon your character or fitness for admission to the
    bar?                                                                         Yes           No

    If so, state facts fully.




25. Give the name and location of each bar association of which you are or have been a member.
                       Name & Address of Each Bar Association of Which You Are a Member.




26. If you have practiced or are practicing law, state the complete names and addresses of three persons
    in each locality where you have practiced law with whom you are personally acquainted, preferably
    other than those referred to in your answers to questions 5, 6, or 7. If you have not practiced law,
    give the same information for each locality in which you have lived for the past five years. You may
    not list persons related to you.



                                                        Page 10 of 12
                         Name                                               Address




27. If you have practiced or are practicing law, give the complete names and addresses of three
    attorneys and two clients who you know. Designate clients specifically. If you have not practiced
    previously, give the complete names and addresses of three attorneys and/or law school professors. In
    both situations, the names you provide should be other than those used for your written
    recommendations or names in questions 5, 6, 7 or 26.
     Attorney, Client
      or Professor                  Name                                    Address




                                                    Page 11 of 12
THE PERSON NAMED AS THE APPLICANT IN THE FOREGOING APPLICATION AND
QUESTIONNAIRE SAYS:

    I am the applicant for admission to practice referred to; I have read carefully the questions in the
foregoing questionnaire and have answered them truthfully, fully and completely, without mental
reservations of any kind, and have not altered or edited the language of any question contained in this
application.

     I fully understand that failure to make full disclosure of any fact or information called for may result
in the denial of my application.

    I fully understand that, prior to my admission, I have a continuing obligation to keep the Board of Bar
Examiners advised of any additional information that would be pertinent to this application or my
qualifications.

    I also understand that I will not be admitted to the New Mexico Bar until any character and fitness
issues arising from the application process have been resolved in my favor.

    I hereby declare under penalty of perjury that the foregoing answers and statements are true and
correct.


State of                               )
                                       )SS.
County of                              )



                                                                       Signature of Applicant


                                                          Executed on
                                                                                       (Date)


                                                          at
                                                                          (Street and Number)



                                                                          (City and State)

Subscribed and sworn to before me this                    day of                      , 20

                                                               My Commission expires on:
    Notary Public

 BEFORE FILING THIS APPLICATION, PLEASE CHECK TO SEE THAT ALL QUESTIONS
    HAVE BEEN ANSWERED AND ALL REQUESTED INFORMATION FURNISHED.


                                                      Page 12 of 12

								
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