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The Connecticut A 62 form serves as an essential application for individuals seeking a special permit to operate a motor vehicle specifically for commuting to and from work. This form is particularly relevant for those who have had their operator's license suspended and need to demonstrate a significant hardship in the absence of a driving permit. To apply, individuals must provide personal details, including their name, date of birth, and operator license number, along with information about their employer and work schedule. It is crucial to note that applicants must pay a non-refundable fee of $100, and those with multiple employers must submit separate applications. The form also requires a clear outline of commuting times and distances, as well as an indication of whether public transportation is available. Additionally, the application process includes a review of the applicant's driving record, and any false statements made can lead to severe penalties. Understanding these key aspects is vital for anyone considering applying for the A 62 special permit in Connecticut.
Documents used along the form
The Connecticut A 62 form is essential for individuals seeking a special permit to operate a motor vehicle to and from work while their regular operator's license is suspended. Several other forms and documents are often required to support this application. Below is a list of these documents, along with brief descriptions of each.
- Employer Verification Form: This document confirms the applicant's employment status and hours. It must be completed and signed by a supervisor or employer to verify the necessity of the special permit.
- Proof of Identity: A valid government-issued ID, such as a passport or state ID, is required to verify the applicant's identity. This helps ensure the information provided on the A 62 form is accurate.
- Driving Record: A copy of the applicant's driving record may be required to assess their driving history. This document provides the DMV with necessary information regarding past infractions or suspensions.
- Quitclaim Deed Form: For those transferring real estate ownership in Texas, a Texas Documents quitclaim deed is essential to ensure the process is completed correctly, especially when no warranties are provided regarding the property’s title.
- Proof of Residence: Documents like utility bills or lease agreements can serve as proof of the applicant's residence. This information is crucial to establish the commuting distance to work.
- Application Fee Payment: A check or money order for the non-refundable application fee of $100 must accompany the A 62 form. This payment confirms the applicant's commitment to the process.
- Transportation Alternatives Form: This document outlines any efforts made by the applicant to secure alternative transportation. It helps demonstrate the hardship faced without the special permit.
These documents collectively support the application for a special permit and ensure that all necessary information is provided for the DMV's review. Proper submission of these forms can significantly influence the outcome of the application process.
Preview - Connecticut A 62 Form
STATE OF CONNECTICUT
DEPARTMENT OF MOTOR VEHICLES
DRIVER SERVICES DIVISION
60 STATE STREET, WETHERSFIELD, CT 06161-2530
TELEPHONE: (860) 263-5720 On The Web At ct.gov/dmv
APPLICATION FOR SPECIAL PERMIT TO
OPERATE A MOTOR VEHICLE TO AND FROM WORK
INSTRUCTIONS:
1. Please print or type.
2. Multiple employment requires separate applications.
3. A $100.00
Operation of motor vehicles requiring a CDL or used for Public Passenger Transportation is PROHIBITED under the Special Permit Program
YOUR OFFICIAL DRIVING RECORD WILL BE REVIEWED AS PART OF THIS APPLICATION.
NAME OF APPLICANT (Last, First, Middle)
DATE OF BIRTH
OPERATOR LICENSE NUMBER/STATE
SEX
M
F
MAILING ADDRESS |
(Number and Street) |
(City or Town) |
(State) |
(Zip Code) |
|
|
|
|
|
|
|
RESIDENCE ADDRESS (If different) |
(Number and Street) |
(City or Town) |
(State) |
(Zip Code) |
|
NAME OF EMPLOYER (If
ADDRESS OF EMPLOYER |
(Number and Street) |
(City or Town) |
(State) |
(Zip Code) |
OCCUPATION |
HOME TELEPHONE NUMBER |
( )
DAYS AND HOURS OF EMPLOYMENT (Specify A.M. or P.M.)
TO BE ISSUED A WORK PERMIT, YOUR SCHEDULE MUST BE CLEARLY IDENTIFIED, AND
MON.
TUE.
THU.
FRI.
SAT.
MAY NOT EXCEED A CONTINUOUS
IF YOU HAVE MORE THAN ONE PLACE OF
EMPLOYMENT, EACH EMPLOYER MUST
WED.SUN.
COMPLETE A SEPARATE APPLICATION.
What is the distance and the commuting time from your residence to your place of employment? |
Is public transportation available |
|
|
|
from your residence to your |
YES |
NO |
|
place of employment? |
||
|
|
|
|
What significant hardship(s) will you suffer without a Special Operator's Permit? |
|
|
|
What efforts have you made to obtain other transportation?
INABILITY TO CONFIRM YOUR EMPLOYMENT MAY RESULT IN DENIAL OF YOUR SPECIAL OPERATOR'S PERMIT.
PRINTED NAME OF SUPERVISOR
SIGNATURE OF SUPERVISOR
X
PRINTED JOB TITLE OF SUPERVISOR
WORK TELEPHONE
( )
NOTICE:
OATH:
Your operator's license is under suspension. If you operate any vehicle outside of the authorized hours, you may be subject to arrest. If you operate a motor vehicle for a purpose not authorized by law, a police officer may make a report to the Commissioner of Motor Vehicles and you will be subject to a civil penalty of up to $500. If your operator's license is suspended for another reason while you are in possession of this permit, the permit is revoked, and if you thereafter operate a motor vehicle you will be subject to double the penalties imposed by law. If you alter or make improper use of the permit, you will be subject to criminal penalties.
I swear or affirm under penalty of false statement in accordance with Connecticut General Statute
PRINTED NAME OF APPLICANT |
SIGNATURE OF APPLICANT |
DATE SIGNED |
X
DMV USE ONLY
PERMIT:
APPROVED
DENIED
DATE PERMIT ISSUED |
(If Approved) |
PERMIT VALID UNTIL (If Approved)
REASON FOR DENIAL
DRIVING HISTORY
NO SIGNIFICANT HARDSHIP
INELIGIBLE
OTHER (Provide Details)
AUTHORIZED SIGNATURE (DMV)
X
PRINTED NAME
DATE SIGNED
Common Questions
What is the Connecticut A 62 form?
The Connecticut A 62 form is an application for a special permit that allows individuals with suspended driver’s licenses to operate a motor vehicle specifically to and from work. This form is administered by the Connecticut Department of Motor Vehicles (DMV).
Who needs to fill out the A 62 form?
What information is required on the A 62 form?
The form requires personal details such as your name, date of birth, operator license number, and contact information. Additionally, you will need to provide your employer’s name and address, your occupation, and your work schedule. It’s also important to describe any hardships you may face without the permit.
Is there a fee associated with the A 62 form?
Yes, there is a non-refundable application fee of $100. This fee must be paid by check or money order made out to the DMV when submitting your application.
What happens if my application is denied?
If your application is denied, the DMV will provide a reason for the denial. Common reasons include not demonstrating significant hardship or being ineligible for the permit. You may want to address the issues noted and consider reapplying if applicable.
Can I use the special permit for any driving purpose?
No, the special permit is strictly for commuting to and from work as outlined in your application. Operating a vehicle outside of the authorized hours or for any other purpose is prohibited and can result in penalties.
How long is the special permit valid?
The special permit is valid until the date specified on the permit itself. If your operator's license is suspended for another reason while you hold the permit, it may be revoked.
What should I do if I have more than one job?
If you have multiple jobs, you must complete a separate A 62 form for each employer. This ensures that each job’s schedule and details are clearly documented.
What kind of hardships should I describe in my application?
When detailing hardships, consider how your inability to drive affects your ability to get to work. This could include financial impacts, job security concerns, or personal circumstances that make public transportation impractical.
Who needs to sign the application?
The application must be signed by you, the applicant, and it also requires the printed name and signature of your supervisor, along with their job title and contact information. This verifies your employment and work schedule.
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Guide to Filling Out Connecticut A 62
Filling out the Connecticut A 62 form is essential for those seeking a special permit to operate a motor vehicle to and from work. Ensure you have all necessary information and documentation ready before you begin. Follow these steps carefully to complete the form accurately.
- Obtain the form: Download or print the Connecticut A 62 form from the DMV website.
- Personal Information: Fill in your name (Last, First, Middle) and date of birth.
- License Information: Enter your operator license number and the state it was issued in.
- Gender: Indicate your sex by marking either M or F.
- Mailing Address: Provide your mailing address, including number and street, city or town, state, and zip code.
- Residence Address: If different from your mailing address, fill in your residence address.
- Employer Information: Write the name of your employer. If self-employed, include your business name and legal proof of self-employment.
- Employer Address: Enter the address of your employer, including number and street, city or town, state, and zip code.
- Occupation: Specify your occupation.
- Home Telephone Number: Provide your home phone number.
- Employment Schedule: Clearly specify your days and hours of employment. Ensure it does not exceed a continuous 12-hour period per day.
- Commuting Details: Indicate the distance and commuting time from your residence to your place of employment.
- Public Transportation: Answer whether public transportation is available from your residence to your workplace by marking YES or NO.
- Hardship Explanation: Describe the significant hardships you will face without the special operator's permit.
- Transportation Efforts: Explain what efforts you have made to obtain other transportation.
- Supervisor Information: Have your supervisor print their name, sign, and provide their job title and work telephone number.
- Signature: Sign the application, affirming that the information provided is true and correct.
- Date: Fill in the date you signed the application.
- Payment: Prepare a check or money order for $100.00 made out to DMV and include it with your application.
After completing the form, review it for accuracy. Submit the application along with the payment to the DMV. They will review your driving record and the information provided. If approved, you will receive your permit. If denied, you will be informed of the reasons for denial.
Dos and Don'ts
When filling out the Connecticut A 62 form, it is important to follow specific guidelines to ensure your application is processed smoothly. Here are some key do's and don'ts:
- Do print or type your information clearly to avoid any misunderstandings.
- Do submit a separate application for each employer if you have multiple jobs.
- Do include a non-refundable application fee of $100, payable by check or money order to DMV.
- Do ensure your work schedule is clearly identified, including days and hours of employment.
- Do provide accurate information about your commuting distance and time.
- Don't attempt to operate a vehicle requiring a CDL or used for Public Passenger Transportation under this permit.
- Don't leave any sections of the application blank; incomplete forms may lead to delays.
- Don't forget to confirm your employment, as failure to do so may result in denial of your permit.
- Don't alter the permit or use it improperly, as this can lead to criminal penalties.