Form B-276 at a glance
What it is: Form B-276 is the Application for Waiver of Registration Fee, Active Service in U.S. Armed Forces, of the State of Connecticut Department of Motor Vehicles.
Who signs: For Present Active Service in U.S. Armed Forces, the commissioned officer enters the Printed Name & Rank of Commissioned Officer and signs on Signature of Commissioned Officer. Sign on Signature of Applicant and enter the Date of Application. Notarization: not valid unless notarized in the Place Sworn, Date Signed and Signature of Duly Authorized Person boxes.
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).
A filled-in Form B-276 example: an active duty soldier applies
How to fill out Form B-276, box by box
Your name, rank and vehicle or vessel
Enter the Name of Applicant (First Name, Middle Initial, Last Name).
Enter your Rank.
Enter the Registration Number, and check Motor Vehicle or Marine Vessel.
Your addresses and operator license
Enter your Mailing Address (No., Street, Town, State) and your Connecticut Resident Address (No., Street, Town); if the Connecticut Resident Address is the same as the Mailing Address, write "SAME".
Enter your CT Operator License No.
If not licensed in CT, specify the state issuing your operator license.
Check one for active duty status
Check one for Active Duty Status: Army, Navy, Marines, Air Force, Army or Air National Guard, or Coast Guard.
Reason for waiver
Under Reason for Waiver, enter the full name and mailing address of the armed forces unit (No Abbreviations), and check all that apply.
Check Present Active Service in U.S. Armed Forces.
The commissioned officer certifies that the applicant has provided evidence of military ID and is in the active service of the Armed Forces of the U.S., and that the applicant was a legal resident of Connecticut at the time of induction. The officer then enters the Printed Name & Rank of Commissioned Officer and signs on Signature of Commissioned Officer.
Check Honorably Separated from Active Service.
Check Separated with a Qualifying Condition as defined in C.G.S. Section 27-103 (not eligible with bad conduct or dishonorable discharge).
Complete Date of Separation, 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.
Signatures and notarization
You certify under penalty of false statement that you were a legal resident of Connecticut at the time of induction, that you are on active duty, or were 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.
Notarization: not valid unless notarized in the Place Sworn, Date Signed and Signature of Duly Authorized Person boxes.
Place Sworn and Date Signed, then "Subscribed and sworn to before me", with the Signature of Duly Authorized Person (C. G. S. §1-24) and the Date Commission Expires or Juris No.
Sources
[1] Form B-276 (Rev. 4-2019), Application for Waiver of Registration Fee, Active Service in U.S. Armed Forces, State of Connecticut Department of Motor Vehicles (the Official source link on this page).