La. Code Crim. Proc. art. 833
AFFIDAVIT ACCEPTING SERVICE AND
WAIVER OF PRESENCE
BEFORE ME, the undersigned authority, did personally come and appear, ____________(CLIENT'S NAME), who after being duly sworn did depose and say:
Affiant acknowledges that he is the defendant in the above captioned criminal matter; that he is aware of all charges pending against him in this matter and that he has retained the services of ____________ (ATTORNEY(S) or LAW FIRM) to represent him in these proceedings;
Affiant is aware that he is scheduled to be in court on the ______ day of ______, 20__ at ___ o'clock and that he has the right to be present on that day but expressly wishes to waive this right and to have his legal counsel appear on his behalf;
Affiant is aware that in his absence, additional court dates could be scheduled in these proceedings and he hereby appoints his above named legal counsel as his agent(s) to accept service of notice to appear for those dates on his behalf, that he accepts service of those dates through his counsel and that he expressly waives his appearance for those dates and authorizes his counsel to appear on his behalf;4.
Affiant understands that the court, in its sole discretion, may revoke its acceptance of this waiver and require that affiant personally appear in open court on subsequent court dates; that his counsel will also be notified; that a notice of appearance will be mailed to affiant at his address of record and that affiant's failure to appear at the subsequent court date could result in the issuance of an arrest warrant, a revocation of appearance bond and/or is punishable as contempt of court;
Finally, Affiant acknowledges that his current address is: _______________(Street, Apt/Lot No, City, State and Zip Code); and authorizes the court to use this address for all notices, unless changed in writing by affiant.
____________________________________
Affiant
SWORN TO AND SUBSCRIBED BEFORE ME, notary, this ____ day of ______, 20__.
____________________________________
NOTARY PUBLIC
La. Cr.P. § 833