APPLICATION FOR WAIVER OF REGISTRATION FEE - ACTIVE ...
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NOTARIZATION (Not valid unless notarized below) Complete DATE OF SEPARATION at left, and submit separation papers to DMV for verification. You are exempt from the payment of registration fees only within two (2) years following the date of honorable discharge or separation from service with a qualifying condition. STATE OF CONNECTICUT DEPARTMENT OF MOTOR VEHICLES On The Web At ct.gov/dmv APPLICATION FOR WAIVER OF REGISTRATION FEE - ACTIVE SERVICE IN U.S. ARMED FORCES B-276 Rev. 4-2019 SIGNATURE OF APPLICANT X CT OPERATOR LICENSE NO. REASON FOR WAIVER FULL NAME AND MAILING ADDRESS OF ARMED FORCES UNIT (No Abbreviations) DATE OF SEPARATION SIGNATURE OF COMMISSIONED OFFICER REGISTRATION NUMBER NAME OF APPLICANT (First Name, Middle Initial, Last Name) MOTOR VEHICLE MARINE VESSEL MAILING ADDRESS (No., Street, Town, State) CONNECTICUT RESIDENT ADDRESS (No., Street, Town - If same as above, write "SAME") SEPARATED WITH A QUALIFYING CONDITION AS DEFINED IN C.G.S. SECTION 27-103 (Not Eligible with bad conduct or dishonorable discharge) PRESENT ACTIVE SERVICE IN U.S. ARMED FORCES X PRINTED NAME & RANK OF COMMISSIONED OFFICER RANK IF NOT LICENSED IN CT, SPECIFY STATE ISSUING OPERATOR LICENSE CHECK ONE FOR ACTIVE DUTY STATUS ARMY NAVY MARINES AIR FORCE ARMY or AIR NATIONAL GUARD INSTRUCTIONS: In order to qualify, YOU MUST HAVE BEEN A CONNECTICUT RESIDENT AT THE TIME OF INDUCTION. Submit a completed/signed/certified application indicating evidence of your active duty with the armed forces of the United States. If you are in the Army or Air National Guard, or are a reservist, submit a copy of your orders showing that you have been called to active duty in the armed forces of the United States within the registration period for which you are applying for a fee waiver. If you have been HONORABLY DISCHARGED or SEPARATED FROM SERVICE WITH A QUALIFYING CONDITION, as defined in Section 27-103 of the Connecticut General Statutes, submit a photocopy of your separation papers, and specify the DATE OF SEPARATION below. (SIGNATURE OF COMMISSIONED OFFICER IN CHARGE is not required) I certify under penalty of false statement that I was a legal resident of Connecticut at the time of induction, that I am on active duty, or was honorably separated from service, or separated from service with a qualifying condition, within the last two years, and that the information given on this application (and in any attachments) is true and accurate. I certify that the above-named applicant has provided evidence of military ID and is in the active service of the Armed Forces of the U.S. I further certify that the applicant was a legal resident of Connecticut at the time of induction. DATE OF APPLICATION COAST GUARD Sec. 12-81. Exemptions. The following-described property shall be exempt from taxation: (53) Motor vehicle of member of armed forces. (a) One motor vehicle belonging to, leased to or held in trust for, any member of the United States armed forces, if such motor vehicle is garaged inside or outside the state; (b) Any person claiming the exemption provided under this subdivision for any assessment year shall, not later than the thirty-first day of December next following the date on which property tax is due in such assessment year, file with the assessor or board of assessors, in the town in which such motor vehicle is registered, written application claiming such exemption on a form approved for such purpose by such assessor or board. Notwithstanding the provisions of this chapter, any person claiming the exemption under this subdivision for a leased motor vehicle shall be entitled to a refund of the tax paid with respect to such vehicle, whether such tax was paid by the lessee or by the lessor pursuant to the terms of the lease. Upon approving such person's exemption claim, the assessor shall certify the amount of refund to which the applicant is entitled and shall notify the tax collector of such amount. The tax collector shall refer such certification to the board of selectmen in a town or to the corresponding authority in any other municipality. Upon receipt of such certification, the selectmen or such other authority shall draw an order on the Treasurer in favor of such person for the amount of refund so certified. Failure to file such application as prescribed herein with respect to any assessment year shall constitute a waiver of the right to such exemption for such assessment year; SUBSCRIBED AND SWORN TO BEFORE ME: DATE SIGNED X PLACE SWORN SIGNATURE OF DULY AUTHORIZED PERSON (C. G. S. §1-24) DATE COMMISSION EXPIRES OR JURIS NO. HONORABLY SEPARATED FROM ACTIVE SERVICE Check all that apply
Transcript of APPLICATION FOR WAIVER OF REGISTRATION FEE - ACTIVE ...
NOTARIZATION (Not valid unless notarized below)
Complete DATE OF SEPARATION at left, and submit separation papers toDMV for verification. You are exempt from the payment of registration feesonly within two (2) years following the date of honorable discharge orseparation from service with a qualifying condition.
STATE OF CONNECTICUTDEPARTMENT OF MOTOR VEHICLES
On The Web At ct.gov/dmv
APPLICATION FOR WAIVER OF REGISTRATION FEE -ACTIVE SERVICE IN U.S. ARMED FORCESB-276 Rev. 4-2019
SIGNATURE OF APPLICANT
X
CT OPERATOR LICENSE NO.
REASON FOR WAIVER FULL NAME AND MAILING ADDRESS OF ARMED FORCES UNIT (No Abbreviations)
DATE OF SEPARATION
SIGNATURE OF COMMISSIONED OFFICER
REGISTRATION NUMBERNAME OF APPLICANT (First Name, Middle Initial, Last Name) MOTORVEHICLE
MARINEVESSEL
MAILING ADDRESS (No., Street, Town, State)
CONNECTICUT RESIDENT ADDRESS (No., Street, Town - If same as above, write "SAME")
SEPARATED WITH AQUALIFYING CONDITIONAS DEFINED IN C.G.S.SECTION 27-103(Not Eligible with bad conductor dishonorable discharge)
PRESENT ACTIVE SERVICEIN U.S. ARMED FORCES
XPRINTED NAME & RANK OF COMMISSIONED OFFICER
RANK
IF NOT LICENSED IN CT,SPECIFY STATE ISSUINGOPERATOR LICENSE
CHECK ONEFOR ACTIVEDUTY STATUS
ARMY NAVY MARINESAIR FORCE ARMY or AIR NATIONAL GUARD
INSTRUCTIONS: In order to qualify, YOU MUST HAVE BEEN A CONNECTICUT RESIDENT AT THE TIME OF INDUCTION.Submit a completed/signed/certified application indicating evidence of your active duty with the armed forces of the United States. If you are in the Army orAir National Guard, or are a reservist, submit a copy of your orders showing that you have been called to active duty in the armed forces of the United Stateswithin the registration period for which you are applying for a fee waiver. If you have been HONORABLY DISCHARGED or SEPARATED FROM SERVICEWITH A QUALIFYING CONDITION, as defined in Section 27-103 of the Connecticut General Statutes, submit a photocopy of your separation papers, andspecify the DATE OF SEPARATION below. (SIGNATURE OF COMMISSIONED OFFICER IN CHARGE is not required)
I certify under penalty of false statement that I was a legal resident of Connecticut at thetime of induction, that I am on active duty, or was honorably separated from service, orseparated from service with a qualifying condition, within the last two years, and that theinformation given on this application (and in any attachments) is true and accurate.
I certify that the above-named applicant has provided evidence of military ID and is in the active service of the Armed Forces of the U.S.I further certify that the applicant was a legal resident of Connecticut at the time of induction.
DATE OF APPLICATION
COAST GUARD
Sec. 12-81. Exemptions. The following-described property shall be exempt from taxation:
(53) Motor vehicle of member of armed forces. (a) One motor vehicle belonging to, leased to or held in trust for, anymember of the United States armed forces, if such motor vehicle is garaged inside or outside the state;
(b) Any person claiming the exemption provided under this subdivision for any assessment year shall, not later than thethirty-first day of December next following the date on which property tax is due in such assessment year, file with theassessor or board of assessors, in the town in which such motor vehicle is registered, written application claiming suchexemption on a form approved for such purpose by such assessor or board. Notwithstanding the provisions of this chapter,any person claiming the exemption under this subdivision for a leased motor vehicle shall be entitled to a refund of the taxpaid with respect to such vehicle, whether such tax was paid by the lessee or by the lessor pursuant to the terms of the lease.Upon approving such person's exemption claim, the assessor shall certify the amount of refund to which the applicant isentitled and shall notify the tax collector of such amount. The tax collector shall refer such certification to the board ofselectmen in a town or to the corresponding authority in any other municipality. Upon receipt of such certification, theselectmen or such other authority shall draw an order on the Treasurer in favor of such person for the amount of refund socertified. Failure to file such application as prescribed herein with respect to any assessment year shall constitute a waiver ofthe right to such exemption for such assessment year;
SUBSCRIBED ANDSWORN TO BEFORE ME:
DATE SIGNED
X
PLACE SWORN
SIGNATURE OF DULY AUTHORIZED PERSON (C. G. S. §1-24) DATE COMMISSION EXPIRES OR JURIS NO.
HONORABLY SEPARATEDFROM ACTIVE SERVICE
Check all that apply
