STATE OF NEW MEXICO

COUNTY OF ____________________

IN THE FIFTH JUDICIAL DISTRICT COURT

_________________________________,

Plaintiff-Petitioner,

vs.                                 NO:_________________

_________________________________,

Defendant-Respondent.

1. Type of case:_________________ Jury:____ Non-Jury:____

2. Assigned Judge: ______________________________________

3. Hearings presently set: ______________________________

4. Specific matters to be heard: ________________________

5. Estimated total time required for this hearing: ______

6. Request submitted by: ________________________________

7. Other attorneys and pro se parties of record entitled to notice: ___________________________________________

______________________________________________________

8. _______ I have consulted with opposing counsel and the

following dates are available to both of us:

______________________________________________________

9. _______ I have called / written opposing counsel to inquire as to available dates and have had no response. I am available on the following dates: _______________

______________________________________________________

         FIRM NAME, ADDRESS, TELEPHONE AND FAX NUMBERS

         By:__________________________________________

[Approved, effective April 1, 1999.]