Form B 230 – Fill Out and Use This PDF

STATE OF CONNECTICUT

DEPARTMENT OF MOTOR VEHICLES

BRANCH OPERATIONS

On The Web at ct.gov/dmv

INFORMATION, INSTRUCTIONS AND DOCUMENTS REQUIRED TO OBTAIN A CONNECTICUT NON-DRIVER IDENTIFICATION CARD

1.Applicant must not possess a valid driver's license or identity card from any state or U.S. territory.

2.Applicant must apply in person to the Department of Motor Vehicles and present the following:

(1)Certified Birth Certificate or Valid Passport plus one additional form of acceptable identification. See reverse for identification information.

(2)Resident Address Verification (ie: utility bill, mortgage or lease papers, postmarked letter). (Exception: see Declaration of Homeless Status)

(3)$22.50 fee. (Exception: see Declaration of Homeless Status)

Connecticut General Statute 1-1h allows a resident of a homeless shelter or other facility for homeless persons to apply for a fee waiver for a Non-driver Identification card. To qualify for a waiver the following information must be completed and submitted to the Department of Motor Vehicles.

To be completed by a director or other authorized official of the Homeless Shelter or other facility as defined in the Regulations of Connecticut State Agencies section 1-1h-8.

NAME AND ADDRESS OF FACILITY/SHELTER

DECLARATION

OF HOMELESS

STATUS

Official: By signing this form the applicant and official at the homeless shelter or other facility are attesting that the individual listed above is a resident of the homeless shelter/facility and is confirming that the Non-Driver Identification fee can be waived.

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.

X

OFFICE USE ONLY

To obtain a new Connecticut Identification Card, one document from Group one must be presented, in addition to one form of identification from the lists below.

To obtain a replacement Identification Card, two forms of identification must be presented.

Two forms of the same identification will not be accepted. Identification being presented must be in the name in which you are applying. Foreign documents other than a passport are not acceptable.

GROUP ONE: (Photocopies will NOT be accepted)

*I-551 Stamp contained in valid foreign passport

*I-94 card contained in valid foreign passport

*Temporary Resident card

*Employment Authorization card

*Refugee Travel document

•Citizenship or Naturalization certificate

•Permanent Resident Card

GROUP TWO: (Photocopies will NOT be accepted)

NOTE: At least one of the documents presented to the commissioner shall include a photograph or computerized image of the applicant or have both the applicant's full legal name and date of birth.

NON U.S. CITIZEN INFORMATION

•Holders of a B1 or B2 Visitors Visa are not eligible for a CT identification card unless a valid Employment Authorization Card (EAC) and verification of an application pending for lawful permanent residence is provided.

•Foreign students with an F1 Visa status must show U.S. Citizenship and Immigration Services (USCIS) document I-20 and verification of current enrollment in a CT school.

•H1B Visa holders are required to show a valid USCIS Employment Authorization Card and an employee verification letter from a Connecticut employer.

•J1 Visa holders are required to show USCIS document DS2019

•All applicants will be verified through USCIS for legal status before an identification card will be issued.