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Get Affidavit Of Louisiana Department Of Revenue Refund Check Endorsement Forgery For Single Filing

D and the affidavit must be executed in the presence of the Notary Public. State of Parish/County of 1. I am first duly sworn and state I am: Taxpayer s First Name Middle Init. Last Name Taxpayer s SSN Mailing Address Email Address City Primary Telephone Number State Zip Secondary Telephone Number 2. I state that the endorsement signature on the Louisiana Department of Revenue refund check listed below was not written or authorized by me and is a forgery as evidenced by the signi.

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