Disclosure forms

If you are faxing a disclosure statement, please keep the confirmation from your fax machine that your transmittal was successful. Due to the volume of statements and calls received, we are unable to confirm receipt of your fax.

For filers using electronic signatures, please see the relevant agency policy.

Table of disclosure forms
Form	Statutory Requirement
Form 401—Gaming Control Board (members/supervisors)	La. R.S. 27:12B and 27:63A
Form 402—Bank/Local Depositing Authority Recusal	La. R.S. 39:1233.1
Form 403—School Board Disclosure	La. R.S. 42:1119B(2)(a)
Form 404—Hospital Service Districts	La. R.S. 42:1119B(2)(b)
Form 405—Public Servant Financial Statement	La. R.S. 42:1114
Form 406—Retirement System Disclosure	La. R.S. 42:1114.2
Form 407—Notice of Fundraiser	La. R.S. 24:50 et seq
Form 408—Gaming Division Disclosure	La. R.S. 27:63B and 27:226B
Form 409—Exemption Disclosure	La. R.S. 42:1123(34)
Form 410—Disaster or Emergency Contracts	La. R.S. 42:1114.3
Form 411—Contract Disclosure	La. R.S. 42:1113D(4)
Form 412—Gubernatorial Transition/Inauguration	La. R.S. 42:1125
Form 413—Complimentary Admission, Transportation, and/or Lodging (fillable version)	La. R.S. 42:1115.2
Form 414—Payment Received for Rendering Services	La. R.S. 42:1111E(2)(a)
Form 415a—Tier 1 Annual Disclosure Statement	La. R.S. 42:1124.1 Tier 1 FAQs
Form 415b—Tier 1 Candidate Disclosure Statement	La. R.S. 42:1124.1 Tier 1 FAQs
Form 416a—Tier 2 Annual Disclosure Statement	La. R.S. 42:1124.2 Tier 2 FAQs
Form 416b—Tier 2 Candidate Disclosure Statement	La. R.S. 42:1124.2 Tier 2 FAQs
Form 416c—Tier 2 Annual Disclosure Statement (fillable version)	La. R.S. 42:1124.2 Tier 2 FAQs
Form 417—Tier 2.1 Annual Disclosure Statement (fillable version)	La. R.S. 42:1124.2.1 Tier 2.1 FAQs
Form 418a—Tier 3 Annual Disclosure Statement (fillable version)	La. R.S. 42:1124.3 Tier 3 FAQs
Form 418b—Tier 3 Candidate Disclosure Statement (fillable version)	La. R.S. 42:1124.3 Tier 3 FAQs
Form 419—Public Official/Professional Musician	La. R.S. 27:96A
Form 420—Legislator Receiving Food, Refreshment, Lodging, and/or Transportation	La. R.S. 42:1123(16)
Form 421—Gubernatorially Declared Disasters and Emergencies – Charitable Giving	La. R.S. 42:1111.1
Form 422—Charter School Banking Disclosure Statement	La. R.S. 17:3991(A)(1)(b)(ii)
Form 423—Spousal Prohibited Income Disclosure Statement	La. R.S. 42:1111C(5)
Electronic Filing Affidavit—Disclosures Electronic Filing Affidavit	Electronic filing affidavit for using the PFD E-Filing system. Mail your notarized affidavit to the Louisiana Board of Ethics. If you already have a username and password for electronically filing campaign finance reports through Leaders Online, the same username and password can be used to log in and access the personal financial disclosure forms on the PFD E-file system.