New Mexico Statutes Chapter 40. Domestic Affairs § 40-13B-3. Confidential substitute address program; application

(1) the applicant's name;

(2) the applicant's statement that the applicant fears for the safety of the applicant, the applicant's child or another person in the applicant's household because of a threat of immediate or future harm;

(3) the applicant's statement that the disclosure of the applicant's residential or delivery address would endanger the applicant, the applicant's child or another person in the applicant's household;

(4) the applicant's statement that the applicant has confidentially relocated in the past ninety days or will relocate within the state in the next ninety days;

(5) a designation of the secretary of state as the applicant's agent for the purpose of receiving mail, deliveries and service of process, notice or demand;

(6) the names and ages of those persons in the applicant's household who will also be participants in the program if the applicant is admitted into the program. Each person in an applicant's household listed in the application shall be considered a separate participant in the program;

(7) the applicant's residential and delivery addresses, if different, the confidentiality of which the applicant seeks to protect;

(8) the applicant's telephone number and email address; and

(9) the applicant's statement under penalty of perjury that the information contained in the application is true.