Crime-Victim and Witness Court-Attendance Leave Request Packet - New Mexico
DOMESTIC-ABUSE COURT AND LEGAL-PROCESS LEAVE REQUEST PACKET
New Mexico — NMSA 1978, §§ 50-4A-2 to -8
Use this packet only for domestic abuse affecting the employee or a family member as narrowly defined below and only for a statutory leave purpose.
1. EMPLOYEE AND EMPLOYER
| Field | Entry |
|---|---|
| Employee | [________________________________] |
| Employer | [________________________________] |
| Position / department | [________________________________] |
| HR / supervisor contact | [________________________________] |
| Preferred confidential contact | [________________________________] |
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 this packet for another relative or household member unless the person independently fits the statutory family-member definition or another law or policy applies.
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.
| Item | Entry |
|---|---|
| Calendar year | [________] |
| Days already used | [________] |
| Hours already used today | [________] |
| Days requested now | [________] |
| Hours requested today | [________] |
| Remaining annual days after request | [________] |
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
| Date | Court or legal-process update | Employee notice | Work adjustment |
|---|---|---|---|
| [________] | [________________] | [________________] | [________________] |
| [________] | [________________] | [________________] | [________________] |
OFFICIAL SOURCE VERIFIED
About this template
- Last updated
- August 11, 2026
- Citations checked
- August 11, 2026
- Jurisdiction
- New Mexico
- Category
- Employment & HR
Legal authority
- NMSA 1978, § 50-4A-2 (domestic-abuse leave, employee, employer, and family-member definitions)
- NMSA 1978, §§ 50-4A-3 to -6 (required leave, notice, verification, benefits, and confidentiality)
- NMSA 1978, §§ 50-4A-7 to -8 (enforcement, remedies, and greater-rights preservation)
Employment documents govern the relationship between a company and its workers, from offer letters and employment agreements through handbooks, performance reviews, and separations. Done right, they set clear expectations, protect against wrongful termination and discrimination claims, and give both sides a record to rely on. Done poorly, they invite lawsuits, agency complaints, and costly disputes.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on August 11, 2026.
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