License Suspension Reinstatement Promotion Participation Form

Louisiana Department of Children and Family Services
Child Support Enforcement Section

License Suspension Reinstatement Promotion
Participation Form
Promotional Period: September 1, 2024 - October 31, 2024

Disclaimer: By submitting this form, you understand and agree that DCFS Communication staff who maintain this website, as well as other staff members, may access the information you provide. However, this information will only be used for Child Support purposes in line with your submission and will be kept confidential and private according to the law.

Full Name:

Case Number(s):

Custodial Parent’s Name:

Child's Name:

Parish of Case:

Residential Address:

City:

State:

Zip Code:

Mailing Address (if different):

City:

State:

Zip Code:

Phone Number:

Email Address:

Employer Info (if applicable):

Employer Name:

Employer Phone Number:

Employer Address:

City:

State:

Zip Code:

I understand that Child Support Enforcement Staff will calculate the total amount I need to pay to participate in the license suspension reinstatement promotion. I will be notified of this amount and provided with payment instructions. I also understand that any reinstatement fees and fines owed to the Office of Motor Vehicles are my responsibility.

Signature of Noncustodial Parent:

Date:

Submission Instructions:

Submit this completed application form through one of the following methods:

Online: Submit directly from the DCFS Website by selecting submit.
Email: LAHelpU.DCFS@la.gov or OntheRoad.DCFS@la.gov
Phone: Call the Customer Service Center at 1-888-524-3578
In-Person: Visit your nearest Child Support Enforcement (CSE) office from 8 a.m. to 4:30 p.m., Monday through Friday.