JUDICIAL DISTRICT COURT, ST. TAMMANY AND WASHINGTON PARISHES

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					      22ND JUDICIAL DISTRICT COURT, ST. TAMMANY AND WASHINGTON PARISHES, STATE OF LOUISIANA
                                                  LOUISIANA CIVIL CODE ARTICLE 102 DIVORCE                                                            FORM A
                                                     With Minor Children of the Marriage

______________________________                                                         DOCKET NUMBER: ________________________
Petitioner
              versus
______________________________                                                         PARISH OF _______________________________
Respondent

Note: Must be completed by mover or mover’s attorney and filed in open court on the date RULE is fixed for hearing. (If attorney for absentee involved, he/she must
testify in open court.)

     A. Dates
        1. Date Petition for Divorce filed:                                          ___________________ Date
        2. Date parties physically separated:                                        ___________________ Date
        3. Date Petition served/waiver executed                                       ___________________ Date
        4. Date Rule filed:                                                           ___________________ Date
        5. Date Rule served:                                                          ___________________ Date
        6. Days elapsed from service of Petition to filing of Rule (Line 3 to Line 4)                 _________________ Days
                                                                                                      (Must be 365 or more Days)
     B. Petition (La. C.C.P. Art. 3951)
        1. Is the petition in the record?                                                        ________ Yes
        2. Is proper jurisdiction expressly alleged in the Petition?                             ________ Yes
        3. Is proper venue expressly alleged in the Petition?                                    ________ Yes
        4. Is the Petition verified by the petitioner?                                           ________ Yes
        5. Is the sheriff’s return showing service, or the waiver of service and notice
            in the record?                                                                       ________ Yes
        6. Were the parties living separate and apart at the time of filing, or
            was the defendant personally served with the Petition and citation?                  ________ Yes

     C.    Rule to Show Cause (La. C.C.P. Art. 3952)
           1. Is the Rule in the record?                                                                               ________ Yes
           2. Does the Rule allege:
               a. proper service of the Petition or waiver of service and notice of the Petition?                      ________ Yes
               b. that 365 days or more have elapsed since service or execution of a written
                    waiver of service and notice of the Petition?                                                      ________ Yes
               c. that the parties have lived separate and apart continuously for 365 days
                    prior to filing of the Rule?                                                                       ________ Yes
           3. Is the Rule verified by the Affidavit of the Petitioner?                                                 ________ Yes
           4. Was the Rule filed within 2 years of the service of the Petition or execution
               of the written waiver of service of the Petition?                                                       ________ Yes
           5. Is the Sheriff’s return showing service or the waiver of service in the record?                          ________ Yes

     D. Affidavit of Mover (La. C.C.P. Art. 3956(5)) or Testimony
        1. Does the record contain the Affidavit of the mover or does the testimony specifically establish that:
             a. The parties have lived separate and apart continuously for at least
                 365 days prior to the filing of the Rule?                                      ________ Yes
             b. The parties are living apart at the time of the execution of the Affidavit?     ________ Yes
             c. The mover desires to be divorced?                                               ________ Yes
        2. Was Affidavit executed after the Rule was filed or was testimony offered at hearing?________ Yes

I hereby certify that I have examined the record in the above captioned case and the information is accurate. This certification is
made to the court for use in the determination of eligibility for divorce in accordance with the provisions of Article 102 of the
Louisiana Civil Code, the Louisiana Code of Civil Procedure Articles 3951, et seq., and revised statutes.

______________________                      _________________________________________                                  ___________________
Date of Record Examination                  Signed by Mover/Attorney for Mover                                         Attorney’s Bar Number

______________________                      _________________________________________                                  ___________________
Date of Certification                       Address                                                                    Telephone Number
                                                       Hearing Officer Recommendation

         Considering the record in this case, the submission of the mover/mover’s counsel and/or the testimony of the witnesses, it
being the finding of the Hearing Officer that all legal requirements for granting a divorce under Louisiana Civil Code Article 102 have
been met.

       IT IS HEREBY recommended that the attached Judgment of Divorce be made the Order of this Court, no objection having
been made by either party.
       ________________, Louisiana, this ____ day of _______________________, 20___.

                                                          _________________________________
                                                                    Hearing Officer
Form A for Louisiana Civil Code Article 102 Divorce (with minor children)
Revised August 2010