APPLICATION FOR WAIVER OF DRIVER'S LICENSE FEE STATE …

1 APPLICATION FOR WAIVER OF DRIVER'S LICENSE FEEBECAUSE OF ACTIVE SERVICE IN ARMED FORCESB-88 REV. 5-2001 STATE OF CONNECTICUTDEPARTMENT OF MOTOR VEHICLESOn The Web At General Statutes, Section 14-50(c). The Commissioner of Motor Vehicles shall waive the operator's LICENSE fee andexamination fee in the case of any person in the active service of the armed forces of the United States who was a legal resident ofConnecticut at the time of his induction; and for one licensing period to any person honorably separated from service who appliestherefore within two years following the date of separation and was a legal resident of connecticut at the time of his AND MAILING ADDRESS OF ARMED FORCES UNITI AM ENTITLED TO A WAIVERBECAUSE OF (Check One)Present Active Service in Armed ForcesHonorably Separated From Active Service(If checked, fill in date of separation and submit separation papers to DMV.)

2 NAME OF APPLICANTCONNECTICUT DRIVER'S LICENSE NUMBERDATE OF APPLICATIONDATE OF INDUCTIONDATE OF SEPARATIONPRESENT HOME ADDRESS (Number and Street)(City or Town)( STATE )(Zip Code)(City or Town)( STATE )(Zip Code) connecticut ADDRESS AT TIME OF INDUCTION (Number and Street)VERIFIED BY (Signature of DMV Employee)I CERTIFY THAT I WAS A LEGAL RESIDENT OF THE STATE OF CONNECTICUTAT THE TIME OF MY INDUCTION AND THAT ALL INFORMATION PROVIDED INTHIS APPLICATION IS CERTIFY THAT THE ABOVE NAMED APPLICANT IS IN THE ACTIVE SERVICEOF THE ARMED OF APPLICANTSIGNATURE OF COMMISSIONED OFFICER IN CHARGE