Connecticut Form H 110 PDF Details

In the state of Connecticut, the Department of Motor Vehicles has set protocols for dealing with abandoned motor vehicles, a process meticulously detailed within the Connecticut H 110 form. This form serves as a pivotal notification for the sale of an abandoned vehicle, delineating the necessity to provide a clear and comprehensive assembly of information, both about the vehicle in question and the intentions surrounding its sale. The form outlines requirements such as the attachment of the H-110 form to the Affidavit of Compliance (H-76), ensuring that former owners are duly notified by mail of the impending sale, and accurately recording details like the vehicle's year, make/model, odometer reading, color, and identification number. Furthermore, it highlights critical financial aspects, specifying the vehicle's approximate value, and delineating costs incurred from storage, towing, and repairs, alongside any other pertinent charges. The form also mandates the disclosure of the seller and purchaser's information, thereby fostering transparency throughout the sale process. Designed to comply with the Connecticut General Statutes, particularly sections 14-110 and 53a-157b, this form is a testament to the state's commitment to lawful and transparent practices in managing abandoned vehicles, ensuring that every sale is executed with integrity and in accordance with legal stipulations.

QuestionAnswer
Form NameConnecticut Form H 110
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesabandoned motor notification form, ct abandoned form, ct h 110, ct abandoned vehicle form

Form Preview Example

STATE OF CONNECTICUT
DEPARTMENT OF MOTOR VEHICLES
TITLE SECTION
60 STATE STREET, WETHERSFIELD, CT 06161
On The Web at ct.gov/dmv

ABANDONED MOTOR VEHICLE SALE NOTIFICATION

H-110 REV. 3-2016

INSTRUCTIONS:

1. Print clearly or type.

2.Attach H-110 to the Affidavit of Compliance (H-76)

3.Mail copy to former owner of record.

YEAR

MAKE/MODEL

ODOMETER READING

COLOR

VEHICLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

VEHICLE IDENTIFICATION NUMBER

 

 

 

 

 

 

APPROXIMATE VALUE OF VEHICLE

 

 

 

 

 

 

 

 

 

 

 

$1500 OR LESS

OVER $1500

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME

 

 

 

 

WAS NOTICE OF INTENT TO SELL SENT TO OWNER?

OWNER OF

 

 

 

 

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RECORD

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF DEALER/REPAIRER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SELLER

ADDRESS OF DEALER/REPAIRER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE VEHICLE PLACED IN CUSTODY OF DEALER/REPAIRER

 

DEALER/REPAIRER LICENSE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STORAGE CHARGES (If any)

 

 

TOWING CHARGES (If any)

 

 

REPAIR CHARGES (If any)

 

 

 

LIEN

$

 

 

 

 

 

$

 

 

 

 

 

INFORMATION

OTHER CHARGES (If any, specify)

 

 

 

 

 

 

TOTAL OF ALL CHARGES

 

 

 

 

 

$

 

 

 

 

 

$

 

 

 

 

 

 

 

NAME (Owner)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

PURCHASER(S)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF SALE

PLACE OF SALE

 

 

 

 

 

 

 

SALES PRICE

 

 

 

 

 

 

 

 

 

 

$

 

 

 

I have mailed this notification to the former owner of record identified above and have complied with all relevant legal requirements. The information provided to the Commissioner of Motor Vehicles herein is subscribed by me, under penalties 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.

SIGNATURE OF SELLER

X

DATE SIGNED

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