Divorce Affidavit Form

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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;
2.
On the ______ day of _____________ 20__ she/he and Defendant,
_____________ separated and they have not lived together as man and wife since
that date.
3.
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.
4.
Rule for Divorce was filed on the ______ day of _____________ 20__, and
service was had on Defendant on the ______ day of ______ 20__.
5.
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

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