La. Code Crim. Proc. art. 894.5
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_____________________DRIVERS LICENSE#____________________
DATE OF BIRTH:____________OFFENSE DATE:_______________________
SS#________________________DOCKET NO:__________________________
TICKET NO:______________________
[] 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.
La. Cr.P. § 894.5