La. Code Crim. Proc. art. 996
TRANSMITTAL OF RECORDS FOR EXPUNGEMENT OF DWI
PURSUANT TO C.Cr.P. Art. 984
____________________________
____________________________
____________________________
________________
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. 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
[] 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.
La. Cr.P. § 996