Louisiana Provisional Custody Mandate Step by Step: How to Fill Out the Form

The Provisional Custody by Mandate under La. R.S. 9:951 is the strongest out-of-court instrument Louisiana offers for delegating a parent's authority to a relative. But the form's legal language trips people up, and a single execution mistake — wrong number of witnesses, unsigned line, missing notary seal — can get the document rejected at a school or clinic. Here is the process from start to finish.

Before You Start: What You Need

Louisiana law requires a written mandate. The walkthrough below follows the suggested form in La. R.S. 9:954, which includes a notary and competent-witness signatures; those execution steps apply when you use that form.

Gather these before sitting down with the form:

• Full legal names of the parent(s) granting authority and the caregiver (mandatary) receiving it
• The child's full legal name, date of birth, and Social Security number (some forms request it; not legally required)
• The desired start and end dates — the mandate cannot exceed one year from execution under La. R.S. 9:952
• A Louisiana Notary Public for the suggested form
• Two competent adult witnesses for the suggested form — they must be present when everyone signs. Use witnesses who are not the notary, parent, or caregiver. Any adult 18 or older who is mentally competent qualifies.

Have the person or people who hold parental authority execute the mandate. A custody decree or other court order may define who can act; check it if you are unsure who must sign. A parent who has been divested of parental authority cannot delegate authority they no longer hold.

Filling Out the Form Field by Field

The suggested statutory form is set out in La. R.S. 9:954. Most printed versions track it closely. Here's what goes in each section:

1. Mandator block (the parent). Full legal name, address, and relationship to the child. If both parents are signing, both names appear here.

2. Mandatary block (the caregiver). Your full legal name and address. This is the person who will be enrolling the child in school, taking them to the doctor, and handling daily decisions.

3. Child identification. The child's full legal name and date of birth. If you're covering multiple children, each child must be individually listed. Some practitioners use one mandate per child for clarity; others list all children on one form. Either is legally valid.

4. Powers delegated. The statutory form grants broad authority for the child's care, education, and health. Read the powers listed and confirm they cover what you need. If you want to add specific limitations or expansions — for example, explicitly authorizing mental health treatment — write them into the designated section. Any power the parent does not possess cannot be delegated.

5. Duration. Enter the start date and end date. The mandate's stated term cannot exceed one year from the execution date. Writing an earlier end date is fine.

6. Signature lines. The parent(s) sign first, then the caregiver (mandatary) signs to accept the delegation.

The Notarization Appointment

If you use the suggested form's notary and witness blocks, complete them together as the form directs. For an authentic act:

• The parent(s) and the caregiver must sign in the physical presence of the notary
• Two adult witnesses must also be physically present and sign the document
• The notary affixes their official seal and signature

For the suggested form, the parent(s), caregiver, notary, and witnesses complete the signing together as the form directs. Do not have the parent sign at home and bring that version later to complete its notary and witness blocks.

Where to find a notary:

• Ask your bank, parish clerk of court, shipping-store notary, or a mobile notary about availability and current fees
• If the parent is incarcerated, ask facility staff how to arrange a notary and the required witnesses

After the Mandate Is Signed

Once you have the executed mandate in hand:

1. Make several copies. Keep the original in a safe place and carry copies for school, the doctor, the dentist, and your own records.
2. File a copy with the child's school and ask them to add it to the enrollment file.
3. File a copy with the child's primary care provider and ask them to scan it into the medical chart.
4. Set a calendar reminder for 30 days before the expiration date. Renewal requires executing an entirely new mandate — you cannot extend the existing one.

Common Mistakes That Get the Form Rejected

• Only one witness signs the suggested form. It has two witness blocks; complete both when using that form.
• Parent signed the suggested form at a different time or location than the notary. Complete its signatures together as the form directs.
• The mandate is expired. Schools and clinics should (and often do) check the date.
• A parent who lost custody signed it. A parent divested of custody by court order has no authority to delegate.

The Louisiana School & Medical Consent guide includes the complete statutory form with line-by-line annotations, a notary appointment checklist, and an expiration tracking tool so the mandate doesn't lapse without warning.

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