Free Appendix C Writ Application Filing Sheet - Louisiana

SUPREME COURT OF LOUISIANA WRIT APPLICATION FILING SHEET NO.___________________________________ TO BE COMPLETED BY COUNSEL or PRO SE LITIGANT FILING APPLICATION TITLE ______________________________________ VS. ______________________________________

Applicant:_______________________________________ Have there been any other filings in this Court in this matter? G Yes G No Are you seeking a Stay Order?_____ Priority Treatment?_____

If so you MUST complete & attach a Priority Form

LEAD COUNSEL/PRO SE LITIGANT INFORMATION
APPLICANT: Address:_______________________________________ ________________________________________ PhoneNo._______________ Bar Roll No.____________ RESPONDENT: Address:________________________________________ ________________________________________ PhoneNo._______________ Bar Roll No.____________ Name:_________________________________________ Name:__________________________________________

Pleading being filed: G In proper person, G In Forma Pauperis Attach a list of additional counsel/pro se litigants, their addresses, phone numbers and the parties they represent.

TYPE OF PLEADING
G Civil, G Criminal, R.S. 46:1844 protection, G Bar, G Civil Juvenile, G Criminal Juvenile, G Other G Surrender, G Adoption, G Child Custody

G CINC,

G Termination,

ADMINISTRATIVE OR MUNICIPAL COURT INFORMATION
Tribunal/Court:_________________________________________ Docket No.________________________________ Judge/Commissioner/Hearing Officer:________________________________ Ruling Date:_____________________

DISTRICT COURT INFORMATION
Parish and Judicial District Court:____________________________________Docket Number:__________________ Judge and Section:______________________________________Date of Ruling/Judgment:_____________________

APPELLATE COURT INFORMATION
Circuit:__________ Docket No.__________________ Action:____________________________________________ Applicant in Appellate Court:_______________________________________________ Filing Date:________________ Ruling Date:____________ Panel of Judges:________________________________________________ En Banc: G

REHEARING INFORMATION
Applicant:_________________________________ Date Filed:___________ Action on Rehearing:_______________ Ruling Date:____________ Panel of Judges:________________________________________________ En Banc: G

PRESENT STATUS
G Pre-Trial, Hearing/Trial Scheduled date:_____________________________, G Trial in Progress, G Post Trial Is there a stay now in effect?______ Has this pleading been filed simultaneously in any other court?______ If so, explain briefly_________________________________________________________________________________ _______________________________________________________________________________________________.
VERIFICATION

I certify that the above information and all of the information contained in this application is true and correct to the best of my knowledge and that all relevant pleadings and rulings, as required by Supreme Court Rule X, are attached to this filing. I further certify that a copy of this application has been mailed or delivered to the appropriate court of appeal (if required), to the respondent judge in the case of a remedial writ, and to all other counsel and unrepresented parties. DATE
O:\lasc\rules\filings0.wpd

SIGNATURE
Revised 12-9-98