Blue Light Permit Certification Form - Fill Out This PDF Online

The Blue Light Permit Certification Form (R-114) is a one-page Connecticut DMV document that authorizes active volunteer firefighters and civil preparedness auxiliary members to display revolving blue lights and sirens on personal vehicles. It collects each member's operator license number, vehicle year, make, registration plate number, and vehicle identification number. A fire chief must certify that all listed volunteers hold valid light permits under Section 14-96p C.G.S. The completed form is due to the DMV Flashing Lights and Sirens Unit by January 31 each year.

Get Form Now Download PDF

Blue Light Permit Certification Form PDF Details

The Blue Light Permit Certification form (R-114), last revised in September 2001, is managed by the Connecticut Department of Motor Vehicles through its Flashing Lights and Sirens Unit in Wethersfield. This document grants eligible volunteer firefighters the legal authority to install and operate revolving blue lights on their personal vehicles when responding to emergency calls.

What Vehicle and Personal Information Is Required?

Each active volunteer must provide their full name, mailing address, and operator's license number. Vehicle details include the year, make, registration plate number, and vehicle identification number. The form accommodates multiple vehicles per member, with additional lines available for those who respond using more than one car or truck.

Who Must Certify the Form?

The fire department's chief executive officer must sign the form to confirm that every listed individual is an active member. This certification also verifies that revolving light permits were issued according to Section 14-96p of the Connecticut General Statutes. Without this signature, the DMV will not process the application, and the volunteer cannot legally display lights or sirens on their vehicle.

When Is the Filing Deadline?

All completed forms must reach the DMV by the last day of January each year. Late submissions may result in the loss of revolving light authorization until the next filing period. In Connecticut, only volunteer fire personnel may apply for revolving blue lights. Other states take different approaches to emergency vehicle lighting. Georgia, for example, issues combined red and blue light permits through its Department of Public Safety. New Jersey requires a separate red light permit application for volunteer firefighters. Some jurisdictions also authorize amber or red revolving lights for additional emergency roles beyond firefighting.

Question	Answer
Form Name	Blue Light Permit Certification Form
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	gov, dmv, ct blue light laws, ct blue light permit

How to Edit Blue Light Permit Certification Form Online for Free

FormsPal's online PDF editor lets you fill out the Blue Light Permit Certification form directly in your browser. Follow these steps to complete your document accurately.

How Do You Fill Out the Form?

Step 1: Click the "Get Form" button at the top of this page to open the R-114 form in our editor.

Step 2: Use the toolbar to type into the required fields. You can also add text, insert images, or sign the form electronically. The editor supports all standard PDF editing operations.

Make sure every required field is filled in correctly before continuing. Missing details may delay your revolving light authorization from the DMV.

1. Begin with the personal and vehicle information fields. Enter your name, address, and operator's license number in the spaces shown below:

Blue light permit certification form showing fields for volunteer name and address

2. Next, fill in the vehicle details for each car or truck that will carry revolving lights: year, make, registration plate number, and vehicle identification number. If you operate multiple vehicles, repeat these fields for each one. Some departments also require a separate vehicle permit for temporary replacement vehicles.

Vehicle details section of CT blue light permit form showing year, make, and registration plate fields

The vehicle sections are the most critical part of this form. Every entry must match your current DMV records exactly to avoid processing delays.

Step 3: Review all completed fields, then click "Done." Your form saves automatically and is ready to download or print. You can return at any time to make changes. FormsPal protects your data and does not share personal information with third parties.