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Applications
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 confirming the social security number and address that the request is mailed from
A state issued identification card and a wallet size photo along with the address that the request is mailed from
Your social security number along with a wallet size photo and the address that the request is mailed from
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.
Click here for Affidavit Application
LSBC Bulletin
11622 Sunbelt Court Baton Rouge, LA 70809
866-257-7901 (toll free)
225-756-3404 (local)
225-756-3410 (fax)
