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The
following form is used when a child is kept by a parent in
violation of a custody order. The affidavit is signed by
the parent seeking return of the minor child before a notary
public. Law enforcement officials will use the affidavit
to obtain a civil warrant from a judge to achieve a return of
the child.
Click for printable page
STATE OF LOUISIANA
PARISH OF __________
AFFIDAVIT OF CUSTODIAL PARENT SEEKING RETURN OF
CHILD KEPT IN VIOLATION OF COURT ORDER
BEFORE ME, the undersigned notary public, personally came and
appeared _____________________________herein called affiant, who
after being duly sworn did depose and say that affiant is the
custodial parent of _____________________by virtue of the
judgment of the ______Court, Parish of _____________, State of
Louisiana, bearing Docket Number _____________, in the matter
entitled _____________________________________________________a
certified copy of which is attached to this affidavit.
Affiant declares that the attached custody and visitation order
is true and correct.
Affiant summarizes the status of any pending custody proceedings
as follows:
The child is being held in this parish by
_________________________ who has refused to return the
child/removed the child from the custodial parent in violation
of the attached custody order.
Affiant further declares that the following facts concerning the
removal of/failure to return the child are true to the best of
affiant’s knowledge, information, and belief:
Affiant desires the return of the child and desires the issuance
of a civil warrant directed to law enforcement authorities to
return the child to the custodial parent pending further order
of the court having jurisdiction over the matter, as authorized
by LSA—R.S. 9:343.10.
The child is currently being held at
______________________________________.
A picture of the child is attached.
____________________________________
AFFIANT
SWORN TO AND SUBSCRIBED, before me, this ________day of
___________199___, in my office in _________________________,
Louisiana.
_______________________________
NOTARY PUBLIC
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