STATE OF LOUISIANA
PARISH OF JEFFERSON
COMBINED VERIFICATION, OATH AND DESIGNATION
BE IT KNOWN that on the day and date set out hereafter, and in the presence of the
undersigned Notary Public,
PERSONALLY, CAME AND APPEARED:
WAYNE CARTER SR a resident of JEFFERSON PARISH, whose address is 5076
WOODCREST DR MARRERO LA 70072
who, after being duly sworn, did depose and say:
1. VERIFICATION:That WAYNE CARTER is the petitioner and I have read the foregoing
petition subscribed by me and the allegations therein contained know the contents thereof, and
the same is true of my own knowledge,
. 2. OATH OF ADMINISTRATOR as indicated above: I am over eighteen (18) years of age and
a citizen of Jefferson Parish , Louisiana ; and I will , faithfully and honestly administrate and
discharge the duties of Administrator of the goods and properties of said decedent according to
laws
THUS DONE AND SIGNED at _________ in the ___________Parish of Louisiana, in the
presence of the undersigned Notary Public after due reading of the whole.
________________________________
WAYNE CARTER SR
State of Louisiana
Parish of ___________________
On this ______ day of _________________, 20_____, before me personally appeared
________________________________, to me known to be the person (or persons) described
in and who executed the foregoing instrument, and acknowledged that he (or they) executed it
as his (or their) free act and deed.
____________________________________
(Signature of notarial officer)
____________________________________
Title (and Rank)
Notary ID Number: _________________,