Records Request / Free

If you are eligible under Louisiana Statute R.S. 44:32 (Title 4, Part I, Chapter 3: Fees) to receive free or reduced-fee copies, complete all information requested below. For assistance, call (225) 505-3766, or email apply@lbopg.org.

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What are you requesting?* Organization or Affiliation* Purpose for Records Request*

Certification for Reduced Copy Fees

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I am a citizen of the State of Louisiana who is indigent and lacks the means to pay $0.25 per copy.

The use of the copies requested will be limited 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 or proprietary use. I understand that if, in the future, the Louisiana Board of Professional Geoscientists determines my use of the documents to be different than represented here, the Board reserves the right to recover cost for copying at the normal rate.

Certification for Free Copies

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The copies requested are solely for use by the federal agency named above.

The copies requested are solely for use by the Louisiana state government agency named above. Please note that local, city, or parish governmental entities are not included.

I certify under penalty of perjury under the laws of the United States of America that the foregoing is true and correct to the best of my knowledge.

Signature of Consent

By typing your name here, you are signing this certification electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this form.

How should we deliver your records? Electronic
Paper
Do you reside outside of the United States? Yes, I currently reside outside of the United States.

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