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Copy Records Request
COPY RECORDS REQUEST
FOR ATTORNEY USE ONLY		 STATE OF CONNECTICUT
 DEPARTMENT OF MOTOR VEHICLES
INSTRUCTIONS: The information you provided in your request is listed below. The information provided by DMV is at the bottom of the form.
CHECK REQUEST
 		FILL IN SECTION UNIT PRICE RECORDS AVAILABLE
 Driver License File Information 1 $20.00 Current Information
 Registration File Information 2 $20.00 Current Information
ATTORNEY E-MAIL ADDRESS
diby@jud.ct.gov
ATTORNEY TELEPHONE NUMBER
860-999-9999
SECTION 1 DRIVER'S NAME (Last, First, Middle Initial)  
 DRIVER'S LICENSE NUMBER

DRIVER'S ADDRESS (Number and Street, City or Town, State, Zip Code)
 DRIVER'S DATE OF BIRTH
SECTION 2 OWNER'S NAME (Last, First, Middle Initial)
 
OWNER'S ADDRESS (Number and Street, City or Town, State, Zip Code)
REGISTRATION PLATE NUMBER
  
DECLARATION: By entering my juris number below I declare under the penalities of false statement as set forth in Section 53a-157b of the Connecticut General Statutes that I will use the information obtained from motor vehicle records only in connection with any civil, criminal, administrative or arbitral proceeding in any court or government agency or before any self-regulating body, including the service of process, an investigation in anticipation of litigation and the execution or enforcement of judgments and orders.
ATTORNEY JURIS NUMBER
 PRINTED NAME OF ATTORNEY
 Local (Without SSO) TEST 		DATE
6/9/2026
 
DMV USE ONLY
LAST KNOWN
ADDRESS ON LICENSE
RECORD
DRIVER'S NAME (Last, First, Middle Initial)
LICENSE #
DOB
DRIVER'S ADDRESS (Number and Street, City or Town, State, Zip Code)
LAST KNOWN
ADDRESS ON
REGISTRATION
RECORD
OWNER'S NAME (Last, First, Middle Initial)
REGISTRATION PLATE #
OWNER'S ADDRESS (Number and Street, City or Town, State, Zip Code)
     
 


  
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