Louisiana Code of Criminal Procedure Tit. XXX, Art. 894.5. Submission of DWI--Code of Criminal Procedure Article 894 Plea Records to office of motor vehicles; forms to be used and completed by the clerk of court

TRANSMITTAL OF RECORDS OF DWI PLEA PURSUANT TO ARTICLE 894

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DATE

OFFICE OF MOTOR VEHICLES

P.O. BOX 64886

BATON ROUGE, LA 70896

NAME ____________________________________________

DRIVER'S LICENSE# _______________________________

DATE OF BIRTH: __________________________________

OFFENSE DATE: ___________________________________

SS# _____________________________________________

DOCKET NO: ______________________________________

TICKET NO: _____________________________________

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Attached is a certified copy of the court minutes, original/certified copy of fingerprints, and proof of the requirements as set forth in the Code of Criminal Procedure Article 556.1, as well as a $50.00 money order or certified funds made payable to the office of motor vehicles, in reference to the above named defendant.

NOTE: Do not use this form to submit records of a DWI expungement pursuant to Code of Criminal Procedure Article 984.