Application for Pardon Consideration

The Governor of the State of Louisiana may pardon only Louisiana convictions. The Governor cannot pardon a federal criminal offense or an offense from another state. If you are seeking a pardon for a conviction in another state, you should contact that state. If you are seeking a pardon for a federal conviction, you should contact the Office of the Pardon Attorney, U.S. Department of Justice, 1425 New York Ave., N.W. Suite 1100, Washington, D.C. 20530 (202) 616-6070.

The Pardon Board utilizes a two-step process for pardon review. The first stage is a qualification review. During stage 1, the Pardon Board will conduct a review of the application (as well as any other materials which may be submitted to the Board for review) to determine if it has merit and should be passed to stage 2 – pardon hearing for further investigation and consideration.

If the application is passed to stage 2, the offender will be assessed a fee in the amount of $150.00 payable to the Department of Public Safety & Corrections for a clemency investigation to be conducted by the Division of Probation & Parole. After the clemency investigation is completed and the case docketed, the offender will have a personal appearance with the Pardon Board. Refer to Board Policy 02-209, “Hearings Before the Board of Pardons” for more information on the hearing process

It is important that each question on the Application is completed and answered fully, truthfully and accurately. The information you provide will help you to present yourself as a responsible and productive citizen. The Pardon Board will review this information in making a decision on your application. The process may take up to three months to complete. Please contact this office by mail or telephone if you have any questions.
Eligibility Requirements:
1. You have been convicted of a violation of Louisiana law, either a felony or misdemeanor.
2. You have no pending charges, outstanding detainers, or any pecuniary penalties or liabilities which total more than $1,000 and result from any criminal conviction or traffic infraction.
3. You have paid all court costs which were imposed in connection with the conviction of the crime(s) for which pardon is requested.
4. You have paid all victim restitution, including but not limited to, restitution pursuant to a court or civil judgment or by order of the Committee on Parole.
5. You are not currently in jail or prison.
6. You must have discharged all sentences, including any type of supervision.
7. You cannot have been considered for a Pardon within the past two years.
Completing the Application

The applicant should take the following steps in completing the application:
1. Complete all required questions on this form.
2. It is the applicant’s responsibility to submit a completed application. The application will not be processed until it is complete. If the application is not complete, the applicant will be notified about the missing information.
3. Each question must be answered fully, truthfully, and accurately.
4. Additional documentation that is relevant to the application may also be attached, including:
  - Letters of support on behalf of the applicant with the application.
  - If the applicant was in the military, include the military's DD-214 with the application.
  - Other attachments that the applicant would like to include may be attached.
5. Application forms must be filled out completely, signed, dated, and notarized where required.
6. The submission of any false information is grounds for immediate denial of the application.

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APPLICANTS SHOULD KEEP A COPY OF THE COMPLETE APPLICATION AND ANY ADDED ATTACHMENTS!
Questions

See the FAQ on the Board’s webpage at www.doc.la.gov/louisiana-board-of-pardons-and-parole/ Call our office at (225) 342-6622 (select menu option “5”)
Timeline

Once a completed application is submitted, the application will be placed on the next available docket for the Stage 1 Qualification Review. Depending on the date of receipt of the application, the next available docket may be thirty (30) or up to forty-five (45) days
THE FOLLOWING ITEMS MUST BE SENT IN WITH YOUR APPLICATION FOR IT TO BE CONSIDERED COMPLETE:
1. Certified Judgment & Sentence on each conviction you wish to have Pardoned (obtainable from the Court Clerk in the Parish of conviction; copies must bear the Clerk’s Seal);
2. Certified statement from the Court Clerk that all restitution, fines, fees, and court costs have been paid in full (must bear the Clerk’s Seal).
3. Current credit report (current within 90 days) (www.freeannualcreditreport.com);
4. Proof of employment or income (if you receive any income send a copy of the latest statement showing the type of income and the amount, i.e. unemployment or SSI); and
5. Proof of residence (current receipt for rent or mortgage payments, lease agreement, or property tax assessment – NOT utility/cable bills).
6. Certified Copy of First Offender Pardon (if applicable)
Please note that the submission of an application does not imply or guarantee that the Pardon Board will favorably recommend a pardon and/or that the Governor will approve the Board's recommendation

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Application for pardon after completion of sentence

Please read the accompanying instructions carefully before completing the application. Type or print the answers in ink. If the application is illegible it will be returned and not processed. Each question must be answered fully, truthfully, and accurately. If the space for any answer is insufficient, you may complete the answer on the optional continuation page or on a separate sheet of paper and attach it to the application. You may attach additional documentation that you believe is relevant to your application. The submission of any false information is grounds for immediate denial of the application. The undersigned applicant requests a Pardon and in support thereof states as follows:
1. Full Name*
First Middle Last Suffix
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone Number:*
Driver’s License Number*
State Issued In*
Date of Birth*
MM slash DD slash YYYY
Place of birth*
Sex*
- Male
- Female
D.O.C. #*
Social Security Number*
Current age*
State in full every other name by which you have been known, including the name under which you were convicted, the reason for your use of another name, and the dates during which you were so known (i.e., include your maiden name, name by former marriage, aliases, and nicknames).*
Are you a United States citizen?*
- Yes
- No
If you are not a U.S. citizen, state your nationality and your alien registration number. If you are a naturalized U.S. citizen, state the date and place of your naturalization.*
Have you ever applied for a Pardon before?*
- Yes
- No
State the date you previously applied.*
MM slash DD slash YYYY
To be eligible to apply, an applicant must have discharged all sentences, including supervision.

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Relief Requested and Reason(s) for Seeking a Pardon
7. Indicate the specific relief requested.*
- Full Pardon, with restoration of firearms
- Pardon without restoration of firearms
- Remission of fines/forfeitures
State in full your reason(s) for seeking a pardon. Please keep in mind that a pardon is ordinarily a sign of forgiveness, not vindication.*

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Prior and Subsequent Criminal Record
8. Aside from the offense(s) for which you seek a Pardon, have you ever been arrested, taken into custody, held for investigation or questioning, charged by any law enforcement authority, or convicted in any court, either as a juvenile or an adult, for any other incident?*
- Yes
- No
For each such incident, state the following: the date, the nature of the charge, the relevant facts, the law enforcement authority involved, the location, and the disposition of the incident. You must list every incident, including traffic violations. You are expected to describe in your own words the relevant facts of each incident. Any omission will be considered a false statement and will be grounds for denial of your application.*

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Substance Abuse and Mental Health Information
14. Have you ever used any illegal drug(s) or abused prescription drugs or alcohol?*
- Yes
- No
Identify the drug(s) used, the dates of drug or alcohol abuse, and the frequency of such use*
15. Have you ever been involved in the illegal manufacture, sale, or distribution of drugs other than the offense(s) for which you seek a Pardon?*
- Yes
- No
Provide complete details of your involvement.*
16. Have you ever sought or participated in counseling, treatment, or a rehabilitation program for drug use or alcohol use?*
- Yes
- No
identify the date(s) of treatment or counseling and the name of the treatment provider.*
17. Have you ever consulted with a mental health professional (psychiatrist, psychologist, or counselor), or another health care provider, concerning a mental health related condition?*
- Yes
- No

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Military Record
23. Have you ever served in the armed forces of the United States?*
- Yes
- No
Date(s) of service:*
Branch(es)*
Serial Number*
Type of Discharge:*
Decoration (if any):*
If you were other than Honorably Discharged, describe in detail the factual circumstances surrounding your discharge.*
Attach a copy of your separation papers (Form DD-214), required*
Max. file size: 50 MB.
24. While serving in the armed forces, did you receive non-judicial punishment, or were you the defendant in any court-martial?*
- Yes
- No
State fully the nature of the charge, the relevant facts, the disposition of the proceedings, and the date thereof. If you were convicted of an offense by court-martial, provide a copy of the court-martial promulgating order.*
Upload court-martial promulgating order, if applicable.
Max. file size: 50 MB.

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Occupational Licensing
25. Have you ever been denied any type of business or professional license, had any such license revoked, or had reinstatement of any such license denied?*
- Yes
- No
Attach a copy of the document(s) evidencing the action and state below the name of the authority taking the action.*
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Max. file size: 50 MB.
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26. Have you ever been granted any type of business or professional license or received the reinstatement of any such license that had been revoked?*
- Yes
- No
Attach a copy of the document(s) evidencing the action and state below the name of the authority taking the action.*
Drop files here or

Max. file size: 50 MB.
If you need more space:

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Charitable and community activities
27. Describe any charitable or civic activities in which you have been engaged, or other contributions you have made to the community, since your conviction. In this regard, you may include the names of any organizations in which you have participated, the time periods of your participation, and your role in these activities.*

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Certification and Personal Oath
I hereby certify that all answers to the above questions and all statements contained herein are true and correct to the best of my knowledge, information, and belief. I understand that any intentional misstatement of material facts contained in this application may cause adverse action on my application for pardon. In making application for a pardon from the Governor of the State of Louisiana, I do solemnly swear that I will be a law-abiding citizen and that I take this obligation freely and without any mental reservation whatsoever.
Respectfully submitted on*
MM slash DD slash YYYY
Signature of applicant*
Upload all required supporting documentation here.*
Drop files here or

Max. file size: 100 MB.
THE FOLLOWING ITEMS MUST BE SENT IN WITH YOUR APPLICATION FOR IT TO BE CONSIDERED COMPLETE:
1. Certified Judgment & Sentence on each conviction you wish to have Pardoned (obtainable from the Court Clerk in the Parish of conviction; copies must bear the Clerk’s Seal);
2. Certified statement from the Court Clerk that all restitution, fines, fees, and court costs have been paid in full (must bear the Clerk’s Seal).
3. Current credit report (current within 90 days) (www.freeannualcreditreport.com);
4. Proof of employment or income (if you receive any income send a copy of the latest statement showing the type of income and the amount, i.e. unemployment or SSI); and
5. Proof of residence (current receipt for rent or mortgage payments, lease agreement, or property tax assessment – NOT utility/cable bills).
6. Certified Copy of First Offender Pardon (if applicable)
Please note that the submission of an application does not imply or guarantee that the Pardon Board will favorably recommend a pardon and/or that the Governor will approve the Board's recommendation

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Authorization for Release of Information
Carefully read this authorization to release information about you, then complete, sign and date it. I authorize any duly accredited representative of the Louisiana Pardon and Parole Board or the Louisiana Department of Corrections, to obtain any information relating to my activities from schools, residential management agents, employers, criminal justice agencies, retail business establishments, courts, or other sources of information. This information may include, but is not limited to, my academic, residential, achievement, performance, attendance, disciplinary, employment history, criminal history, arrest, conviction, including the pre-sentence investigation report, if any, medical, psychiatric/psychological, health care, financial and credit information.

I understand that, for financial or lending institutions and certain other sources of information, a separate specific release may be needed (pursuant to their request or as may be required by law), and I may be contacted for such a release at a later date.

I further authorize the Louisiana Pardon and Parole Board or the Louisiana Department of Public Safety & Corrections, or any other authorized state agency, to request criminal record information about me from criminal justice agencies for the purpose of determining my suitability for a Pardon.

I authorize custodians of records and sources of information pertaining to me to release such information upon request of any duly accredited representative of the Louisiana Pardon and Parole Board or the Louisiana Department of Public Safety & Corrections or any state agency authorized above regardless of any previous agreement to the contrary.

I understand that the information released by records custodians and sources of information is for official use by the State of Louisiana only for the purposes of processing my application for a pardon, and may be re-disclosed by the State of Louisiana only as authorized by law.

I understand that pursuant to Act 52 of the 2016 Legislative session, should my application advance to Stage 2 of the process, I agree to pay an assessment fee of $150.00 to the Louisiana Department of Public Safety & Corrections for a clemency investigation to be conducted by the Division of Probation & Parole.

Copies of this authorization that show my signature are as valid as the original release signed by me. This authorization is valid for one (1) year from the date signed.
Signature*
Date signed*
MM slash DD slash YYYY
Full name*
Other names used*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone number*
Email*

Enter an email address here to receive a copy of your digital application submission. This is optional but highly recommended.

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Character affidavit on behalf of
In support of the application of the above-named applicant for a Pardon from the Governor of the State of Louisiana. I,*
Residing at*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Occupation*
How many years have you personally known this applicant?*
Except as otherwise indicated below, applicant has behaved since the conviction in a moral and law-abiding manner. My knowledge of applicant’s reputation, conduct and activities, including whether the applicant has been arrested or had any other trouble with the public authorities and has been steadily employed, is as follows:*
Consent*
I do solemnly swear that the foregoing information is true and correct to the best of my knowledge, information and belief.*
Signature of affiant*
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.

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Application for Pardon Consideration

Step 1 of 15

APPLICANTS SHOULD KEEP A COPY OF THE COMPLETE APPLICATION AND ANY ADDED ATTACHMENTS!

Application for pardon after completion of sentence

Offense(s) for which pardon is sought

Relief Requested and Reason(s) for Seeking a Pardon

Prior and Subsequent Criminal Record

Biographical Information

Substance Abuse and Mental Health Information

Civil and financial information

Military Record

Occupational Licensing

Charitable and community activities

Certification and Personal Oath

Authorization for Release of Information

Character affidavit on behalf of

Home / Prison Programs & Resources / Pardons & Parole

Application for Pardon Consideration

Application for Pardon Consideration

Step 1 of 15

APPLICANTS SHOULD KEEP A COPY OF THE COMPLETE APPLICATION AND ANY ADDED ATTACHMENTS!

Application for pardon after completion of sentence

Offense(s) for which pardon is sought

Relief Requested and Reason(s) for Seeking a Pardon

Prior and Subsequent Criminal Record

Biographical Information

Substance Abuse and Mental Health Information

Civil and financial information

Military Record

Occupational Licensing

Charitable and community activities

Certification and Personal Oath

Authorization for Release of Information

Character affidavit on behalf of