Louisiana Petitioner’s Affidavit Article 103 Form
Use this form to attach to the divorce petition when filing for divorce in Louisiana.
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:
- She/He is the Petitioner in the above proceeding and is duly authorized to make this affidavit;
- On the ______ day of _____________ 20__ she/he and Defendant, _____________ separated and they have not lived together as man and wife since that date.
- 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.
- Rule for Divorce was filed on the ______ day of _____________ 20__, and service was had on Defendant on the ______ day of ______ 20__.
- Petitioner desires a divorce from the Defendant, _________ pursuant to La. Civil Code Article 103.
SWORN TO AND SUBSCRIBED before me this ______ day of ______ 20__.