Crime-Victim and Witness Court-Attendance Leave Request Packet - New Mexico

CRIME-VICTIM COURT AND LEGAL-PROCESS LEAVE REQUEST PACKET

New Mexico — Domestic-Abuse Leave and Earned Sick Leave Routes

Select the applicable route. Sections 1–10 request leave under the Promoting Financial Independence for Victims of Domestic Abuse Act for the employee or a family member defined by that Act. Section 11 requests available earned sick leave under the Healthy Workplaces Act for legal proceedings connected to domestic abuse, sexual assault, or stalking affecting the employee or a family member as defined by that Act. The two routes have different eligibility, notice, and documentation rules; complete only the selected route.

ROUTE A — PROMOTING FINANCIAL INDEPENDENCE FOR VICTIMS OF DOMESTIC ABUSE ACT (SECTIONS 1–10)

1. EMPLOYEE AND EMPLOYER

The statutory employer definition includes private employers, state agencies, units of local government, and school districts and does not state a minimum employee-count threshold.

2. COVERED-PERSON GATE

The person affected by domestic abuse is:

• ☐ The employee
• ☐ A minor child of the employee
• ☐ A person for whom the employee is legal guardian

Relationship or guardianship basis, if applicable: [________________________________]

Do not use Route A for another relative or household member unless the person fits its statutory family-member definition. Route B has a different family-member definition.

3. COVERED LEAVE PURPOSE

The requested leave is to:

• ☐ Obtain or attempt to obtain an order of protection
• ☐ Obtain or attempt to obtain other judicial relief from domestic abuse
• ☐ Meet with law-enforcement officials regarding the domestic abuse
• ☐ Consult with an attorney regarding the domestic abuse
• ☐ Consult with a district attorney's victim advocate regarding the domestic abuse
• ☐ Attend a court proceeding related to the domestic abuse

Court, agency, attorney, advocate, or law-enforcement office: [________________________________]

Case identifier, using the minimum necessary information: [________________________________]

Meeting, consultation, or proceeding date and time: [________________________________]

Expected work absence: [DATE / START / END]

4. ANNUAL AND DAILY LIMITS

Domestic-abuse leave is intermittent paid or unpaid leave for up to 14 days in a calendar year and up to 8 hours in one day.

Requested intermittent dates and hours: [________________________________]

5. NOTICE

For emergency domestic-abuse leave, the employee or the employee's designee must notify the employer within 24 hours after the leave begins.

• ☐ Planned leave notice delivered under the employer's procedure
• ☐ Emergency leave began on [DATE / TIME]
• ☐ Employee gave emergency notice within 24 hours
• ☐ Employee's designee gave emergency notice within 24 hours

Notice date, time, method, and recipient: [________________________________]

Employee or designee: _________________________ Date: ______________

6. VERIFICATION, IF REQUIRED

If the employer requires verification, the employee must timely furnish one of the following:

• ☐ Police report indicating that the employee or qualifying family member was a victim of domestic abuse
• ☐ Order of protection
• ☐ Other court evidence produced in connection with an incident of domestic abuse
• ☐ Written statement from the employee's attorney
• ☐ Written statement from a district attorney's victim advocate
• ☐ Written statement from a law-enforcement official
• ☐ Written statement from a prosecuting attorney

For a written professional statement, the statement confirms that the employee or qualifying family member appeared or is scheduled to appear in court in connection with an incident of domestic abuse.

Secure delivery date and method: [________________________________]

Providing court evidence does not waive confidentiality or privilege between the employee and the employee's advocate or attorney.

7. PAY, BENEFITS, AND LEAVE TREATMENT

The employee may use the following consistently with employer policies:

• ☐ Accrued sick leave: [HOURS]
• ☐ Other available paid time off: [TYPE / HOURS]
• ☐ Compensatory time: [HOURS]
• ☐ Unpaid leave time: [HOURS]

To the extent permitted by law, the employer may not withhold accrued pay, health-coverage insurance, or another accrued benefit because the employee takes domestic-abuse leave. Time taken as domestic-abuse leave may not be included in calculating benefit eligibility.

8. CONFIDENTIALITY AND EMPLOYER RESPONSE

The employer must keep verification information and the fact of the domestic-abuse incident, request or use of leave, and related employee statements confidential. Disclosure is limited to employee consent, a court or administrative-agency order, or another requirement of federal or state law.

• ☐ Covered-person gate confirmed
• ☐ Covered statutory purpose confirmed
• ☐ Annual and daily limits confirmed
• ☐ Planned or emergency notice route confirmed
• ☐ Verification received or calendared
• ☐ Paid, compensatory, or unpaid treatment recorded: [________________________________]
• ☐ Leave approved without interference, restraint, denial, or retaliation
• ☐ Confidential-storage and access controls applied
• ☐ Counsel review required

Employer representative: _____________________ Date: ______________

9. ENFORCEMENT ALERT

The Workforce Solutions Department may investigate and enforce the Act. The Department and the employee may bring an action in a court of competent jurisdiction to enjoin further violations, recover actual damages, or both, together with costs and reasonable attorney fees. Other common-law, federal, and state remedies and greater rights under another law, contract, collective bargaining agreement, policy, plan, or program are preserved. Obtain prompt legal advice; this packet is not a complaint.

10. CHANGE LOG

11. ROUTE B — HEALTHY WORKPLACES ACT EARNED SICK LEAVE REQUEST

☐ This employer is covered by the Healthy Workplaces Act; the United States, New Mexico, and its political subdivisions are excluded from that Act's employer definition. NMSA § 50-17-2(F).

I request available earned sick leave for an absence necessary because of ☐ domestic abuse ☐ sexual assault ☐ stalking affecting ☐ me ☐ a family member under NMSA § 50-17-2(G). The requested time is for ☐ preparing for legal proceedings ☐ participating in legal proceedings ☐ obtaining services or assisting that family member with those activities. NMSA § 50-17-3(C)(4).

Employee: [________________] Employer: [________________]

Relationship to affected family member, if applicable: [________________]

Dates and expected duration of absence: [________________]

Available earned sick leave requested: [____] hours. Employer's applicable 12-month leave period: [________________]

Request by ☐ employee ☐ person acting on employee's behalf; delivered ☐ orally ☐ in writing on [DATE / TIME] to [RECIPIENT]. For foreseeable leave, I made a reasonable effort to give advance notice and avoid undue disruption; for unforeseeable leave, notice was given as soon as practicable. NMSA § 50-17-3(D)-(E).

For this earned-sick-leave route, an employer may request reasonable documentation only after two or more consecutive work days of leave. The employee may choose a police report, court-issued document, or signed statement from a victim-services organization, clergy member, attorney, advocate, the employee, a family member, or another person affirming the covered purpose. The statement need not follow a set format or be notarized. The employer may not demand details of the abuse, assault, or stalking, delay the leave while awaiting documentation, or disclose the reason except as § 50-17-5(D) permits.

Documentation, if lawfully requested: ☐ pending ☐ provided securely on [DATE] by [METHOD]

Employee or representative signature: ____________________ Date: [________]

Employer response / leave recorded: [________________] Date: [________]

OFFICIAL STATUTE SOURCE

• New Mexico Compilation Commission — current Chapter 50 NMSA 1978 PDF