Fill and Sign the Louisiana Open Account Form

________________ : _______ JUDICIAL DISTRICT COURT ________________ VS : PARISH OF _______ , LOUISIANA ________________ : DOCKET NO. _______ ________________________________________________________________ PETITION ON OPEN ACCOUNT Petitioner, ________________ , a Louisiana corporation domiciled in the Parish of _______ , State of Louisiana, respectfully represents: l. Made Defendant herein is ________________ , domiciled in the Parish of _______ , Louisiana. 2. Defendant is justly and truly indebted unto your Petitioner in the true and full sum of ________________ ($ _______ ) DOLLARS, together with legal interest from date of judicial demand until paid, reasonable attorney's fees and all costs of these proceedings, for the following: 3. Defendant received on open account various goods and services from ________________ , for the total amount of ________________ ($ _______ ) Dollars, as evidenced by the attached invoices of ________________ attached hereto and marked as Plaintiff's "Exhibit l" in globo. 4. Defendant has failed and refused to pay on this account despite amicable demand being made upon defendant by Certified Mail, Return Receipt letter dated _______ ____ , 20 ____ , a copy of which is attached hereto and made a part hereof, and marked as plaintiff's "Exhibit 2". Plaintiff, therefore, is entitled to reasonable attorney's fees. WHEREFORE, premises considered, Petitioner, ________________ , prays that after due proceedings that there be Judgment in favor of plaintiff and against Defendant, in the full sum of ________________ ($ _______ ) DOLLARS, together with legal interest from date of judicial demand until paid, reasonable attorney's fees, and all costs of these proceedings. ____________________________ ________________ Attorney at Law ________________ _______ , LA _______ ( ____ ) _______ La. Bar Roll No. ____ Please serve Defendant through its duly authorized agent for service of process: ________________ ________________ _______ , LA _______ STATE OF LOUISIANA PARISH OF _______ BEFORE ME, the undersigned Notary Public, personally came and appeared ________________ , who, after being duly sworn, did depose and state that: (l) He is the ________________ of ________________ , and is duly authorized to make this affidavit. (2) He is familiar with the account of ________________ , and that the attached invoices are a true and correct statement of the services provided to this debtor, on whose account there is a balance due and owing of ________________ ($ _______ ) Dollars. ___________________________________ ________________ President ________________ SWORN TO AND SUBSCRIBED before me this _____ day of _______ , 20 ____ . __________________________________ NOTARY PUBLIC