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Affidavit Application

This form must be completed and returned to our office in order for the Louisiana State Board to send Certification of hours to which ever state you would like to transfer to; along with proof of identification. This form of identification must be a copy of the following:

A  state issued driver's license or ID card

If you have any questions please contact our office.  Once we receive this infomation, we will submit a copy of your records to the state which you requested them to be sent to.

Your first Affidavit is free; additional requests are $15.00 each.

Please email form to

Click here for Affidavit Application
11622 Sunbelt Court Baton Rouge, LA 70809 866-257-7901 (toll free) 225-756-3404 (local) 225-756-3410 (fax)