STATE OF LOUISIANA
Judicial District Court for the Parish of Jefferson
You are hereby summoned in the name of the State of Louisiana and of the 24
Judicial District Court for
the Parish of Jefferson, to appear before the aforesaid Court at the office of the Clerk of the 24
Court for the Parish of Jefferson, on the ______ day of ________________________, 20 ____, at ______ o’clock
_____.M to testify to the truth in the above entitled and numbered cause from day to day until finally discharged.
Herein fail not under penalty of the law.
This service was issued by the Clerk of Court on the _____ day of ____________________, 20 ____.
Issued at the request of:
Jon A. Gegenheimer, Clerk of Court
Judicial District Court
Parish of Jefferson, State of Louisiana
ATTORNEY’S NAME: __________________________________________
Deputy Clerk of Court
CITY/STATE/ZIP: ______________________________________________ Bar Roll No. ______________________
Received on the __________ day of ____________________________, 20 ______ and on the ___________ day of ______________________________,
20 ______ served the above named party as follows:
PERSONAL SERVICE on the party herein named: _______________________________________
DOMICILIARY SERVICE on the party herein named by leaving the same at his domicile in this parish in the hands of
______________________________________, a person of suitable age and discretion residing in said domicile and whose name and other facts
connected with this service, I learned by interrogating the said person, said party herein being absent from his residence at the time of said
Parish of _______________________, this ________ day of ___________________, 20 _____.
File original and two copies with the clerk of court.