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Fill and Sign the Before Me the Undersigned Authority Notary Public Personally Came and Appeared Form

Fill and Sign the Before Me the Undersigned Authority Notary Public Personally Came and Appeared Form

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Open the document and fill out all its fields.
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A F F I D A V I T STATE OF LOUISIANA PARISH OF ________________ BEFORE ME, the undersigned authority, Notary Public, personally came and appeared ________________, who did depose and state that: A copy of the attached subpoena for the medical records of ________________ which was issued to ________________ has been personally served upon ________________ (or his counsel of record) at least seven (7) days prior to the date that the medical records are to be produced. I have personal knowledge of the facts set forth hereinabove. THUS DONE AND PASSED on this ____ day of____________, 20____ at ________________, Louisiana. _______________________________ ________________ ________________________________ NOTARY PUBLIC

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