Lake Charles City Court
AFFIDAVIT SAMPLE
STATE OF LOUISIANA PARISH OF CALCASIEU SUIT NUMBER: ________
Before me, the undersigned authority, duly qualified in and for the aforesaid parish and state personally came and appeared JANE DOE, agent for LAKE RENTAL PROPERTIES, LLC phone #: 337-123-4567 who declared unto me that they are located at: 800 BIBLO STR., LAKE CHARLES LA 70601 and that JOHN DOE of 456 LAKE ST., LAKE CHARLES LA 70605 is indebted to said petitioner in the amount $800.00 for RENT
Basis of Suit: please explain why you are suing the defendant using 2 or 3 sentences. The defendant owes rent for the months of January and February, with said rent being $400.00 per month. After amicable demand, the defendant has failed to pay. Therefore the plaintiff, JANE DOE, is asking for the sum of $800.00 with interest from the date of Judicial Demand and all costs of court.
And that the said debtor has made no effort to pay same in spite of amicable demands.
Sworn to and subscribed before me this ___ day of ______, 200_. ______________________________
PETITIONER
______________________________
DEPUTY CLERK OF COURT
**Do not sign affidavit until filing at City Court, unless you have it notarized**