DER THE LICENSE ISSUED TO ME BY A FOREIGN STATE FOR THE REASON GIVEN BELOW. NAME DATE OF BIRTH CONNECTICUT ADDRESS NAME OF FOREIGN STATE ADDRESS ON FOREIGN STATE LICENSE REASON FOREIGN STATE LICENSE CANNOT BE SURRENDERED: I DECLARE UNDER PENALTIES OF FALSE STATEMENT, THAT THE STATEMENTS MADE ABOVE ARE TRUE AND CORRECT. SIGNATURE OF OPERATOR X DATE SIGNED .
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How to fill out the CT Q-12 online
The CT Q-12 form is an affidavit used in lieu of surrendering a foreign state operator's license. This guide provides a comprehensive overview of the form's components and step-by-step instructions to assist users in completing the process online.
Follow the steps to successfully complete the CT Q-12 online
- Click the ‘Get Form’ button to access the CT Q-12 form and open it in your online editor.
- Begin by filling in your personal information in the designated fields, including your full name and date of birth. Ensure that the information is accurate and matches your identification documents.
- Enter your current Connecticut address. This information is crucial for verification purposes, so double-check for any errors or typos.
- Provide the name of the foreign state that issued your operator's license. This section is important for identifying the relevant jurisdiction.
- Fill in the address as it appears on your foreign state license. This should match the documentation provided by the issuing authority.
- Clearly state the reason why you are unable to surrender your foreign state license in the provided field. Be concise and truthful in your explanation.
- Sign the form electronically to affirm that the information provided is true to the best of your knowledge. Use the designated area for your signature. Remember that any false statement may lead to penalties.
- Finally, indicate the date on which you are signing the form. This is required for processing your application.
- Once all fields are completed, review your form for completeness and accuracy. After verifying your information, you can save changes, download, print, or share the form as needed.
Complete your CT Q-12 form online today for a seamless processing experience.
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