Fill and Sign the Disavow Paternity Form

_______________ : ________ JUDICIAL DISTRICT COURT VS : PARISH OF _______ , LOUISIANA _______________ : DOCKET NO. ________ __________________________________________________________________ PETITION TO DISAVOW The petition of _______________ , a person of the full age of majority, respectfully represents that: l. _______________ (hereinafter called Petitioner) is a citizen and resident of and is domiciled in ________ , ________ Parish, Louisiana. 2. _______________ and _______________ (hereinafter called Defendants) are citizens and residents of and are domiciled at ________ , ________ , Louisiana ______ . 3. Petitioner and Defendant, _______________ , were married on ________ ___ , 20 ___ , of which marriage four and only four children were born, namely: _______________ , _______________ , _______________ , and _______________ . 4. The parties herein have been physically separated since ________ ___ , 20 ___ , and did not cohabitate as husband and wife since that date. 5. Petitioner is informed and believes that Defendant gave birth to a child, _______________ , on or about ________ ___ , 20 ___ , which child was born of an adulterous relationship between Defendant and another man to be named at trial, if necessary. 6. Although the child was apparently conceived during the existence of the marriage between Petitioner and Defendant or within three hundred (300) days from the dissolution thereof, Petitioner is not the father of the child, _______________ ; on the contrary, the child is the issue of Defendant and another man, who will be named at trial, if necessary, and was conceived as a result of the adulterous relationship existing between them. 7. Consequently, Petitioner disowns the child whose name is _______________ . 8. The child has no legal representative and, therefore, it is necessary that an attorney at law be appointed to represent her in these proceedings. 9. The mother of the child is a necessary party to this action. WHEREFORE, Petitioner prays that: l. An Attorney at Law be appointed to represent the child born to the Defendant; 2. The child, through the Attorney at Law and Defendant, the child's mother, be served with a copy of this Petition and cited to appear and answer it according to law; 3. There be judgment herein ultimately decreeing that the said infant child is not Petitioner's child; and 4. Defendant, _______________ , be cast with all costs of these proceedings. Respectfully Submitted: _________________________________________ _______________ Attorney for Petitioner _______________ ________ , LA ______ ( ___ ) ______ La. Bar Roll No. ______ Please personally serve Defendant, _______________ , as follows: _______________ ________ , LA ______ The subject child, _______________ , through the Court-appointed attorney. _______________ : ________ JUDICIAL DISTRICT COURT VS : PARISH OF ________ , LOUISIANA _______________ : DOCKET NO. ________ _________________________________________________________________ _ O R D E R Considering the foregoing petition: IT IS ORDERED that ___________________, an Attorney at Law practicing within ________ Parish, Louisiana, be appointed herein to represent the minor child, _______________ , referred to in the above petition. THUS DONE AND SIGNED this ______ day of _______________, 20 ___ , at ___________ , ________ , Louisiana. _____________________________ _ J U D G E STATE OF LOUISIANA PARISH OF ________ BEFORE ME, the undersigned Notary Public, duly commissioned and legally qualified, personally came and appeared _______________ , who, being first duly sworn, did depose and say that: l. He is the Petitioner in the above and foregoing petition; 2. He has read the same; and 3. All of the allegations of fact contained therein are true and correct, to the best of his knowledge, information and belief. _______________________________ _______________ SWORN TO AND SUBSCRIBED before me this ______ day of __________, 20 ___ . _________________________________ NOTARY PUBLIC