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LOUISIANA DEPARTMENT OF PUBLIC SAFETY
OFFICE OF MOTOR VEHICLES
Section:III Safety Responsibility LawsEffective: 06/17/1998
Number:9.00Revised: 08/21/2009

INSTALLMENT AGREEMENT/PROMISSORY NOTE/GARNISHMENT
To view Louisiana Statutes: http://www.legis.state.la.us/

AUTHORITY
R.S. 32:873(6)
R.S. 32:874 A(3)

DEFINITION
An installment agreement/promissory note is a written agreement whereby an individual has agreed to make monthly installment payments until all damages, property and/or medical have been paid in full.

A motion of garnishment is a court ordered document whereby a specified sum is automatically deducted from wages to satisfy a creditor, or in the case of accidents, to satisfy property and/or medical damages resulting from the accident.

REQUIREMENTS
Completion of the Installment Agreement / Promissory Note form to include:
  • Total amount owed, and terms of agreement.
  • Agreement portion must be signed *and dated by the person agreeing to pay.
  • Acceptance portion must be signed *and dated by the person who is receiving the money.
  • Promissory note must include the amount and terms of the agreement, and must be signed by the party making the payments. A letter indicating acceptance must accompany the agreement.
  • Signature of two witnesses in the agreement portion and in the acceptance portion, or notarized.
3023.pdf
Installment Agreement (R 0409)