Clerk Or Civil District Court Cover Sheet Template Page 2
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4CIVIL DISTRICT COURT FOR THE PARISH OF ORLEANS
STATE OF LOUISIANA
421 LOYOLA AVENUE, ROOM 402
NEW ORLEANS, LA
No.
COVERSHEET - ALL ACTIONS FOR DIVORCE OR ANNULMENT
The petitioner is required to furnish this information to the Clerk of Court in
accordance with LA R.S. 40:57.
HUSBAND'S INFORMATION
Last Name
First Name
Second Name
Race
Age
Number of This Marriage
Usual Place of Residence:
City or Town
Parish
State
WIFE'S INFORMATION
Maiden Name
First Name
Second name
Race
Age
Number of This Marriage
Usual Place of Residence:
City or Town
Parish
State
DIVORCE INFORMATION
Place of This Marriage - City or Town
State
Date of Marriage
Number of Children Under 10
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