Connecticut Form B 58 PDF Details

For individuals residing in Connecticut, keeping personal information current with the Department of Motor Vehicles (DMV) is a straightforward process, thanks to the B-58 form. This crucial form not only allows for a simple update to one's address across operating licenses, non-driver IDs, and vehicle, including vessels, registrations but also provides an opportunity to affirm or withdraw consent for organ and tissue donation. Tailored for joint owners as well, the completion process mandates the inclusion of both individuals' license or ID numbers, ensuring the form's applicability to a broad spectrum of residents. Importantly, the form requires to be diligently filled, signed, and dated by all applicants, emphasizing accurate transmission of information from the current registration documents. A unique feature of the B-58 form is its explicit instruction for applicants to manually update their license and registration documents with the new address, alongside obtaining address labels for further validation. Additionally, it underscores the necessity of informing the local post office about the address change, albeit clarifying that this modification does not extend to voter registration. The completion of this form signifies the applicants' acknowledgment of legal responsibilities, with a clear warning against providing false information under the Connecticut General Statutes. This comprehensive approach embedded within the B-58 form encapsulates the state's commitment to maintaining accurate records while promoting civic responsibility towards organ and tissue donation.

QuestionAnswer
Form NameConnecticut Form B 58
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesB 58 operators license fillable form

Form Preview Example

CHANGE OF ADDRESS AND ORGAN/TISSUE DONOR STATUS

STATE OF CONNECTICUT

B-58 REV. 12-2013

DEPARTMENT OF MOTOR VEHICLES

 

On The Web At ct.gov/dmv

INSTRUCTIONS - PLEASE PRINT INFORMATION

1.Joint owners may use this form if both operators' license/non-driver ID numbers are listed.

2.Form must be signed and dated by all applicants.

3.Copy information from your current registration. If more than four (4) marker plate numbers, use additional change of address forms.

4.Keep your license/non-driver ID(s) and registration(s). On the registration(s), cross out the old address and write the new address in the space provided. Affix the new address label to the BACK of your license/non-driver ID(s). Labels can be obtained from any Police Department or by calling DMV's Phone Center.

5.In addition to DMV, PLEASE contact your local post office to change your official mailing address.

CHECK CHANGES

OPERATOR'S LICENSE/NON-DRIVER ID

MOTOR VEHICLE REGISTRATION

VESSEL REGISTRATION

I CONSENT TO ORGAN AND TISSUE DONATION AND WISH TO BE IN THE DONOR REGISTRY

I NO LONGER WISH TO BE IN THE DONOR REGISTRY

CHANGE OF ADDRESS IS NOT FOR VOTER REGISTRATION PURPOSES

NAME (Last, First, Middle Initial) - APPLICANT 1

NAME (Last, First, Middle Initial) - APPLICANT 2

(NEW) MAILING ADDRESS (No. and Street, City or Town, State, Zip Code)

RESIDENT ADDRESS, IF DIFFERENT FROM MAILING ADDRESS

TAX TOWN - Connecticut town where vehicle in the normal course of operation most frequently leaves from, returns to or remains.

SIGNATURE

DATE

X

SIGNATURE

DATE

X

The information provided to the Commissioner of Motor Vehicles herein is subscribed by me, the undersigned, under penalty of false statement, in accordance with the provisions of Section 14-110 and 53a-157b of the Connecticut General Statutes. I understand that if I make a statement which I do not believe to be true with the intent to mislead the commissioner, I will be subject to prosecution under the above-cited laws.

OPERATOR'S LICENSE/NON-DRIVER ID NUMBER(S) (9 digits)

1.

STATE

2.

VESSEL INFORMATION

NUMBER

EXPIRATION DATE

 

 

REGISTRATION INFORMATION

TYPE OF PLATE (Camper, Passenger, Comb., etc)

MARKER PLATE NUMBER

EXPIRATION DATE

Month Year

Month Year

Month Year

Month Year

FORMER ADDRESS

Mail this form to: DMV Data Entry, 60 State Street, Wethersfield CT 06161

How to Edit Connecticut Form B 58 Online for Free

With the help of the online tool for PDF editing by FormsPal, you can fill out or alter Connecticut Form B 58 right here and now. The editor is consistently updated by our team, receiving new awesome functions and turning out to be greater. To start your journey, go through these basic steps:

Step 1: Open the PDF doc inside our editor by clicking the "Get Form Button" above on this page.

Step 2: The editor helps you customize your PDF file in a variety of ways. Improve it by adding your own text, adjust what is originally in the PDF, and include a signature - all when you need it!

If you want to finalize this form, ensure that you enter the necessary details in every single blank field:

1. The Connecticut Form B 58 involves certain information to be entered. Ensure the next fields are completed:

Ways to prepare Connecticut Form B 58 portion 1

2. Just after filling out this part, go on to the next stage and fill in the essential particulars in all these blanks - OPERATORS LICENSENONDRIVER ID, STATE, NUMBER, EXPIRATION DATE, VESSEL INFORMATION, TYPE OF PLATE Camper Passenger, MARKER PLATE NUMBER, EXPIRATION DATE, REGISTRATION INFORMATION, Month, Year, Month, Year, Month, and Year.

TYPE OF PLATE Camper Passenger, OPERATORS LICENSENONDRIVER ID, and Month of Connecticut Form B 58

Always be extremely careful when filling in TYPE OF PLATE Camper Passenger and OPERATORS LICENSENONDRIVER ID, since this is where most users make some mistakes.

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