NEW MEXICO STATE LAND OFFICE
COLLATERAL ASSIGNMENT
Collateral Assignment No: ____________
The undersigned ______________________________________________________________
and wife or state of incorporated
whose address is:___________________________________________________, the holder of State ______________ No. _______________ which expires on the ______ day of __________________,
(Specify type of lease or contract)
20_____, does hereby assign, transfer and set over unto _____________________________________
__________________________________________________________________________________
Address____________________________________________________________________________ the aforesaid (Purchase Contracts) (Lease) covering the following described lands of the State of New Mexico, to wit:
SUBDIVISION SECTION TOWNSHIP RANGE ACRES
This assignment is made as collateral security for the payment of indebtedness owing by the undersigned to the assignee herein amounting to $ ________________, and the payment of further advances that may hereafter be made by the assignee herein to the undersigned, not exceeding; however, the sum of $ ________________. The sum of $70.00 for a filing fee must accompany this application.
If the above indebtedness includes any of the following, please indicate such information: Private lands (owned and leased) ________________ acres; Federal Lands (including U.S. Forest Services, BLM, etc.) ________________ acres; Other state leased lands ________________ acres and lease number(s) __________________________________________________________; State Lands under Purchase Contract(s) ________________________ acres and Contract number(s) ______________________________________________.
This assignment is made subject to all terms and provisions of Sections 19-7-37 through 19-7-45, New Mexico Statutes, Annotated, 1978 Compilation.
________________________________________
ASSIGNOR (if Corporation, print or type name of Corporation and Executing Officer)
_________________________________ ________________________________________
SECRETARY (Corporation only) WIFE (if applicable)
FEE: $70.00 When you provide a check as payment, you authorize the State of New Mexico to either use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction.
S-50 (Revised 10/22/2015) (1 of 2)
(PERSONAL ACKNOWLEDGMENT)
STATE OF ____________________)
) ss
COUNTY OF __________________)
The foregoing instrument was acknowledged before me this __________ day of ____________________, 20_____, by __________________________________________________.
My Commission Expires: ____________________ __________________________________
NOTARY PUBLIC
(ACKNOWLEDGMENT BY ATTORNEY-IN-FACT)
STATE OF ____________________)
) ss
COUNTY OF __________________)
The foregoing instrument was acknowledged before me this __________ day of ____________________, 20_____, by ________________________________________________ as attorney-in-fact in behalf of _______________________________________________________.
My Commission Expires: ____________________ __________________________________
NOTARY PUBLIC
(ACKNOWLEDGMENT BY CORPORATION)
STATE OF ____________________)
) ss
COUNTY OF __________________)
The foregoing instrument was acknowledged before me this __________ day of ____________________, 20_____, by (Name)______________________________________________, (Title)_________________________________________________________________________________________________________ of (Corporation)_______________________________________________________________________________________________ a ___________________________________________ corporation, on behalf of said corporation.
My Commission Expires: ____________________ __________________________________
NOTARY PUBLIC
APPROVAL OF THE COMMISSIONER
Office of the Commissioner of Public Lands
Santa Fe, New Mexico
I hereby certify that the within Collateral Assignment was filed in my office on ___________________ __________________________________, approved by me and to be effective as to the State of New Mexico on _________________________________________________.
_____________________________________
COMMISSIONER OF PUBLIC LANDS STATE OF NEW MEXICO
S-50 (Revised 10/22/2015) (2 of 2)
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