Free Affidavit of Correctness of Account - Louisiana

_______________________________________ Plaintiff
VS.

SUIT NO. _____________ DIV. ____ BATON ROUGE CITY COURT CITY OF BATON ROUGE

_______________________________________ Defendant

STATE OF LOUISIANA

AFFIDAVIT OF CORRECTNESS OF ACCOUNT
BEFORE ME, the undersigned authority, personally came and appeared:

_________________________________________, who, being first duly sworn, did depose and say that
AFFIANT

he/she is employed by Plaintiff, that he/she is personally familiar with the account at issue in this litigation, that the balance due by ______________________________________________, Defendant, to______________________________________________, Plaintiff, is $___________________, as more fully described in Exhibit I, attached hereto and made a part hereof, that the services and/or products described in Exhibit I were actually rendered and/or provided to defendant, and that, despite repeated amicable demands, Plaintiff has been unable to collect this debt. _____________________________________________
AFFIANT

SWORN TO AND SUBSCRIBED, before me, Notary Public, on the ____ day of ____________, 20____.

________________________________________________
NOTARY PUBLIC

Civil ­ Affidavit of Correctness of Account (05-13-03)