DIRECTIONS: If you are eligible to receive free or reduced copy fees, complete all information requested below. Please TYPE or PRINT. Sign and date the bottom of the form. Submit the completed form by mail or email, along with your completed Public Records Request Form, to the Custodian of Records, 5825 Florida Blvd. Suite 2000, Baton Rouge, LA 70806 or by email to Publicrecords@ldaf.la.gov or by pressing the submit button below.
Name
*
First Name
Last Name
Organization/Company
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
Confirmation Email
example@example.com
Phone Number
*
Please enter a valid phone number.
Certification for Reduced Copy fees
*
I am a citizen of the State of Louisiana who is indigent and lacks the means to pay $0.25 per copy. I will limit the use of the copies requested to a public purpose (including, but not limited to use in a hearing before any government regulatory commission). I further certify that this information is not for personal proprietary use. I understand that if, in the future, the Louisiana Department of Agriculture and Forestry determines my use of the documents to be different than represented here, the Department reserves the right to recover cost of copying at the normal rate.
Certification for Free Copies The copies requested are solely for use by a Louisiana state agency or a federal agency named on the first line of this page. Please note that local, city, or parish governmental entities are not included.
Signature
*
Date
*
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Month
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Day
Year
Date
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Step 1:
COMPLETE all information on this form.
Step 2:
SUBMIT completed form to the Custodian of Records by mail to 5825 Florida Blvd., Suite 2000, Baton Rouge, LA 70806, by email to Publicrecords@ldaf.state.la.us or by pressing the submit button below. DO NOT ATTACH PAYMENT WITH THIS FORM.
Step 3:
WAIT to receive invoice, if applicable. Once received, send payment as indicated on the invoice.
Name
*
First Name
Last Name
Organization/Company
*
Address
*
Street Address
Street Address Line 2
City
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Confirmation Email
example@example.com
Requested Information: Please specify locations; business names; grower names; LDAF representative names; contents of list (contacts, email addresses); type of license (arborist, landscape horticulturist, pesticide dealer, structural pest control operator, grain dealer, warehouse, milk processor, hemp grower, etc.); permit (floral dealer, nursery stock dealer, cut flower dealer, sweet potato dealer, apiary, livestock dealer, etc.); registration (livestock auctioneers, commercial animal feed, fertilizer, seed dealer, etc.): and/or type of complaint/investigation (fire report, meat inspection, recorded brand, certificate of inspection and measurement, motor fuel quality, etc.). Attach additional pages, if necessary.
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Date range of requested information:
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I certify that I am 18 years of age. Requestor's Signature:
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Date
Delivery Information (Check Appropriate Box)
*
Email requested documents. Fees will apply. Will be invoiced.
Segregate records for in-person review. You will be notified when the records are ready for review.
Make copies for pick-up in person. Fees will apply. Will be invoiced.
Make copies and mail them to me. Fees will apply. Will be invoiced.
Payment Method & Authorization
CARD, CHECK OR MONEY ORDER Duplication Fees: $0.25 per page (8½ X11 & 8 ½ X14)
Please be advised pursuant to La. Const. Art. XII, § and Title 44 of the Louisiana Revised Statutes, every person has the right to examine public records, except as otherwise provided by law. If your request is denied, specific reasons for denial will be provided. We are authorized to charge fees for providing copies of records, pursuant to La. R.S. 44:32.
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