<p> PUBLIC DOCUMENT DEPOSITORY PROGRAM</p><p>ANNUAL PUBLICATIONS REPORT FORM </p><p>All Louisiana state agencies, as defined by R.S. Title 25: §121.1, are required to report the agency’s publications to the Recorder of Documents. Submit this completed form annually during the month of July by email to [email protected] or send it via fax, mail, or hand-delivery to the address given at the bottom of this form. Note: list each title only once, even if multiple issues were published during the twelve month period (July 1-June 30) covered by the report (e.g., list “Minutes” only once, even if published quarterly). If a publication changes significantly (e.g., changes title, ceases publication) during the year, please promptly submit the Publication Update Form, available from the Recorder’s web page for agencies at http://www.state.lib.la.us/state- employees/depository-library-program/state-agencies.</p><p>Agency Name: Terrific State Agency Today’s Date: 7/14/2017</p><p>Your Name: Ms. Jane X Job Title: Director of Something Services</p><p>Email: [email protected] Are you the liaison officer for this Yes No Phone: 504-123-5678 agency? Liaison Name: Liaison Job Title:</p><p>Liaison Email: Liaison Phone: Secondary Contact Secondary Contact Mr. Bob Y Administrative Assistant Name: Job Title: Secondary Contact Secondary Contact [email protected] 504-123-5679 Job Email: Phone:</p><p>Select Frequency From Check All Format(s) Published Publication Title: Dropdown Menu: During Reporting Period: Minutes of board meetings Monthly Hard Copy Digital</p><p>Journal of Louisiana Something Quarterly Hard Copy Digital</p><p>Annual report Annually Hard Copy Digital</p><p>Guide to Something Important One time publication Hard Copy Digital</p><p>Manual for Citizen Constituents Irregularly--As often as needed Hard Copy Digital</p><p>Quarterly Progress Report Quarterly Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Page 1 of 2 Select Frequency From Check All Format(s) Published Publication Title: Dropdown Menu: During Reporting Period: Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Choose an item. Hard Copy Digital</p><p>Thank you for your continued support of the Louisiana Public Document Depository Program.</p><p>RECORDER OF DOCUMENTS STATE LIBRARY OF LOUISIANA 701 NORTH 4TH STREET BATON ROUGE, LA 70802 PHONE 225.342.4929 Fax 225.219.4804</p><p>PDDP State Agency Publications Report Form Page 2 of 2</p>