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Get LA DPSMV 1968 2012-2023

TE APPLICATION MUST BE SUBMITTED FOR EACH LOCATION AND EACH CO-OWNER PLEASE TYPE OR PRINT Business Name (must read exactly the same on both the bond and on the contract) Physical Address of Business Parish City State Zip Code State Zip Code Mailing Address City Phone No. Fax No. ( ) ( ) Email Address: (Mandatory) Previous License No. /Authorization No. (if applicable) Bond No. Surety’s Phone No. Name of Surety Company Address City State Zip Code 1. Has any license ever been .

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