Louisiana Petitioner’s Affidavit Article 103 Form

Petitioner’s Affidavit Article 103.doc Use this form to attach to the divorce petition when filing for divorce in Louisiana.

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STATE OF LOUISIANA

 

PARISH OF _____________

 

 

BEFORE ME, the undersigned Notary Public, duly commissioned and legally qualified in and for the Parish and State aforesaid, personally came and appeared _________ who, being first duly sworn, did depose and say that:

 

  1. She/He is the Petitioner in the above proceeding and is duly authorized to make this affidavit;

 

  1. On the ______ day of _____________ 20__ she/he and Defendant, _____________ separated and they have not lived together as man and wife since that date.

 

  1. Petition for Divorce was filed on the ______ day of _____________ 20__, and Defendant accepted service on the ______ day of ______ 20__.  The parties have lived separate and apart for more than 180 days prior to the filing of the petition.

 

  1. Rule for Divorce was filed on the ______ day of _____________ 20__, and service was had on Defendant on the ______ day of ______ 20__.

 

  1. Petitioner desires a divorce from the Defendant, _________ pursuant to La. Civil Code Article 103.

 

 

_______________________________

Signature

Name:

 

 

 

 

 

 

 

 

 

 

 

SWORN TO AND SUBSCRIBED before me this ______ day of ______ 20__.

 

 

_________________________________

NOTARY PUBLIC