November 2, 2022

Affidavit of Request
For Notice of Seizure and Sale

I, Art Placer©, a real live fresh and blood, breathing, natural non-fictional being, do solemnly, sincerely, and
squarely affirm that the following facts contained in this Affidavit of Request For Notice of Seizure and Sale are,
to the best of my knowledge and belief, true, correct, complete and not misleading and the truth. In
accordance with Louisana R.S. 13:3886 the undersigned party does hereby request that the Sheriff of West
Baton Rouge Parish, Louisana notify the undersigned party at the following address:

Creditor: Art Placer©

Address: 333Lynn Avenue, Jackson, Mississippi 39206

in the event of seizure by the Sheriff of West Baton Rouge Parish of the following described property owned
by ___________________________________________:

Address: __________________________________________
Property Description: __________________________________________

or any present and future improvements, component parts, fixtures, rights, ways, privileges, servitudes or
easements appurtenant or related to the above descibed property.

Creditor, Art Placer© further request that this request be filed in the mortgagw records of Eest Baton Rouge
Parish, Louisana. Attached is payment in the amount of $10.00 in the form of United States Currency
delivered herewith to the sheriff of West Baton Rouge Parish, Louisana as required by 13:3886.

Sincerely,
BY:_____________________________________
Art Placer.©
Creditor
All Rights Reserved; UCC 1-308-Without Prejudice

NOTICE
Using a notary on this document does not constitute any adhesion, nor does it alter my status in any manner. The purpose for notary is verification and
identification only and not for entrance into any foreign jurisdiction.

ACKNOWLEDGMENT

STATE OF LOUISANA )
) ss. JURAT
PARISH OF EAST BATON ROUGE )

THIS DAY, specially appeared before me, the undersigned _____________________________, flesh and blood living man; in
said PARISH and STATE; the within named who acknowledged that he signs and executes the within foregoing instrument on the day and
year therein mentioned.

GIVEN under my hand and seal of office, this _______ day of _______________________ 2022.

_______________________________________ Notary Stamp

Notary Signature

MY COMMISSION EXPIRES:________________

REQUEST AND PAYMENT RECEIVED

SHERIFF OF EAST BATON ROUGE PARISH

BY: ______________________________
DATE:_____________________________

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REQUEST FOR NOTICE OF SEIZURE – F1BSEC13: As provided by R.S.13:3886, a party desiring to be notified of
the seizure of a specified immovable, may file a fixture subject to a chapter 9 security interest, may file a
request of this type in the mortgage records of the parish where the affected immovable is located. The party
must also pay $10.00 to the Sheriff of the parish in which the request is filed.

WORD KEY EXPLANATION:

[DATE] Date of request.

[PARISH] Parish in which immovable property or fixture

is located.
[CREDITOR] Name of creditor requesting notice.

[Mailing Address] Mailing address of creditor.

[Owner] Record owner of the property

[Property Description] Legal description of property. Including municipal

number or street address where applicable.

[FORM] Indicates means of payment.

[AGENT] Name of person appearing for creditor.

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