Fill and Sign the Louisiana Separate Property Form

RESERVATION OF INCOME UNITED STATES OF AMERICA FROM SEPARATE PROPERTY STATE OF LOUISIANA BY [_DECLARANT_] PARISH OF [_PARISH_] BE IT KNOWN that on [_Date_] , before me, [_NOTARY_] , a Notary Public duly commissioned and qualified in and for the aforesaid parish and state, and in the presence of the undersigned witnesses, personally came and appeared: [_DECLARANT_] (Tax Identification Number [_TIN_] ), wife of [_Husband_] , domiciled in [_Domicile_Parish_] , Louisiana and having as her present mailing address [_Address_] ; who declared that a community of acquets and gains exists under the laws of the State of Louisiana between herself and her husband, [_Husband_] ; that she owns separate and paraphernal property; that in accordance with the provisions of Article 2339 of the Revised Civil Code of Louisiana, as amended, she does hereby reserve all fruits of her separate and paraphernal property, wherever located and however administered, whether such fruits be natural or civil, including rental, royalty, bonus, delay rental, shut-in payments and all other income, or from the result of labor or otherwise, for her own separate use and benefit; and that it is her intention to administer such property separately and alone. THUS SIGNED ON the date indicated above at [_City_Parish_] , Louisiana, in the presence of the undersigned Notary Public, qualified in said State and Parish, and the undersigned competent witnesses, who have signed with the parties after due reading of the whole. WITNESSES: ____________________ __________________________ [_DECLARANT_] ____________________ __________________________ [_NOTARY_] , NOTARY PUBLIC * * * * * * * * * * RESERVATION OF INCOME - F1CMAT1 : By this declaration, filed as provided in R.C.C. Article 2339, a married person may reserve as separate property income from separate property. The declaration may be general or apply only to particular items of property. WORD KEY : EXPLANATION : [_DECLARANT_] Name of spouse making declaration. This name should be consistent with the name used in any acquisition of immovable property. [_PARISH_] Parish of execution. [_Date_] Date of execution. [_NOTARY_] Notary before whom act is executed. [_TIN_] Tax Identification Number of person making declaration. [_Husband_] Name of declarant's husband. In this example, the wife makes the declaration. [_Domicile_Parish_] Parish of declarant's domicile. [_Address_] Mailing address of declarant. [_City_Parish_] City and parish of execution.