Current as of January 01, 2019 | Updated by FindLaw Staff
Welcome to FindLaw's Cases & Codes, a free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw's Learn About the Law.
A. Notwithstanding the provisions of R.S. 13:841 et seq. the clerks of the several district courts shall provide to any person who makes a request the following affidavit and acknowledgment form and shall notarize and record the affidavit subject to a fee to be established by the clerk or the recorder of mortgages.
B. The affidavit and the acknowledgment concerning the distinction or identity of a person shall comply with the requirements of R.S. 9:5501 and 5503 if it provides all the information required or set forth in the following form:
STATE OF LOUISIANA PARISH OF__________
AFFIDAVIT
Before me, the undersigned authority __________, personally came and appeared:
|
(Affiant) |
, |
(marital status and mailing address), |
|
who after being duly sworn, deposed as follows: |
|
I, |
(Affiant) |
, |
being of sound mind |
|
acknowledge and understand that any intentional falsification of information I am about to provide shall subject me to penalties for the crime of injuring public records and false swearing. |
|
My full name is ____________________. I am ________ years old
|
|
|
and I was born on |
(Month) (Day) (Year) |
|
at |
(City, Parish/County and State of Birth) |
. |
My social
|
|
security number is ______________________________. I presently reside at ____________________ and my previous addresses for the preceding 10 years were ____________________, ____________________. Name and address of my employer ____________________; Name and address of location of employment ____________________; Occupation ____________________; Marital status ____________________,
|
|
If married full name of spouse |
(Maiden name if applicable) |
; |
|
spouse's social security number ____________________. |
I HEREBY AFFIRM AND ATTEST, under penalty of law, that I am not the same person as the debtor or debtors named in the following described recorded judgments, liens, privileges, or mortgages:
(1) (Identification of recorded judgments, liens, privileges, or mortgages.)
I HEREBY FURTHER AFFIRM AND ATTEST, that on the ____ day of _____________, ______, I mailed a copy of the affidavit to each judgment creditor listed in the affidavit at his last known address by registered mail and hereby submit proof of said certified mailing.
I HEREBY FURTHER AFFIRM AND ATTEST, that the Judgment Creditor has failed to comply with R.S. 9:5501 and I hereby execute this affidavit of identity to establish that I am not the same person identified as the debtor in the said recorded judgments, liens, privileges, mortgages or other such documents itemized above.
Thus done, read and signed at ____________________,
State of Louisiana, this ______ day of __________, _______.
|
WITNESSES: |
|
|
_________________________________________________ |
_________________________________________________ |
|
_________________________________________________ |
Affiant |
|
______________________ |
|
|
Notary Public |
|
|
Acknowledgment |
|
I,(we), |
(Name of Judgment Creditor) |
hereby |
|
acknowledge that the above named affiant is not the same
person identified or named in the above identified or described
|
|
(judgment, lien, privilege, or mortgage) |
and that the property of |
|
the affiant is not subject to the judicial mortgage resulting from the judgment. |
Thus done, read and signed at __________, State of Louisiana, this day of the month of___, ___.
Judgment Creditor
|
____________________ |
|
Notary Public |
Cite this article: FindLaw.com - Louisiana Revised Statutes Tit. 9, § 5501.1. Sworn affidavit; form - last updated January 01, 2019 | https://codes.findlaw.com/la/revised-statutes/la-rev-stat-tit-9-sect-5501-1/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
Was this helpful?