Louisiana Code of Criminal Procedure Tit. XXXIV, Art. 996. Submission of expungement records to office of motor vehicles; forms to be used and completed by the clerk of court

PURSUANT TO C.Cr.P. Art. 984

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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. Additionally, a $50.00 money order or certified funds made payable to the office of motor vehicles, in reference to the above named defendant is attached; or

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Attached is a copy of the certified letter received from office of motor vehicles indicating that all of the required documents were previously filed in conjunction with the requirements of Code of Criminal Procedure Article 894 and are on file. Additionally, a $50.00 money order or certified funds made payable to the office of motor vehicles is attached.

NOTE: Do not use this form to submit records of a DWI plea pursuant to Code of Criminal Procedure Article 894(A)(5).”