Louisiana Department of Transportation and Development
P.O. Box 94042
Baton Rouge, Louisiana 70804-9042
Attention: Truck Permit Section
Fax Number: 225-377-7108
Application for:
Harvest Season Permit$10.00 per vehicle (per year)
Farm and Forest Products in their natural state
Please enclose a check, money order, credit card information below or DOTD charge account number
Issued to (Company Name): |
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Paid by : |
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Customer I.D. Number: |
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Customer I.D. Number: |
Address : |
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Address: |
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Phone Number: |
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Phone Number: |
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Fax Number: |
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Email address: |
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Complete name and address if mailed to is other than above: |
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VEHICLE INFORMATION (This permit can only be tied to the pulling unit) |
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Vehicle Make |
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License No. |
Lic. St. |
Last 10 digits of VIN Number |
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Permit Effective Date |
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CREDIT CARD INFO (if applicable): |
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Card Type: |
€ |
Visa |
€ |
MasterCard |
€ |
American Express |
Card Number: |
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Expiration Date: |
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Name on Credit Card: |
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Phone# of Cardholder: |
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****************************THIS IS NOT A PERMIT****************************
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Signature of applicant |
Date |