Free Microsoft Word - Civil - Affidavit Verifying No Civil Litigation _01-29-03_. - Louisiana


File Size: 74.6 kB
Pages: 1
Date: May 12, 2003
File Format: PDF
State: Louisiana
Category: Court Forms - Local
Author: AEddy
Word Count: 127 Words, 920 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://brcc.brgov.com/Forms%20IS%20Permissions/Civil%20Interactive%20PDFs/Civil%20-%20Affidavit%20Verifying%20No%20Civil%20Litigation.pdf

Download Microsoft Word - Civil - Affidavit Verifying No Civil Litigation _01-29-03_. ( 74.6 kB)


Preview Microsoft Word - Civil - Affidavit Verifying No Civil Litigation _01-29-03_.
CITY OF BATON ROUGE
VS.

FILE/TRAFFIC NO.: __________________ BATON ROUGE CITY COURT CITY OF BATON ROUGE STATE OF LOUISIANA

AFFIDAVIT VERIFYING NO CIVIL LITIGATION
I do hereby declare, under penalty of perjury*, that I have not been sued in connection with this proceeding, nor has any civil judgment been rendered against me concerning the facts that resulted in this traffic infraction.
Baton Rouge, Louisiana, on this _________ day of ______________, 20 ____.

_____________________________
Defendant

SWORN TO AND SUBSCRIBED, BEFORE ME, on this _____ day of ____________, 20 ____.

_________________________________ Notary Public

* I understand that an INTENTIONALLY FALSE DECLARATION herein would subject me to PROSECUTION for PERJURY, which is a FELONY, PUNISHABLE upon conviction by IMPRISONMENT UP TO FIVE (5) YEARS at HARD LABOR (La R.S. 14:123).

Civil ­ Affidavit Verifying No Civil Litigation (04-25-03)