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Form B-225 Special Permit Application and Impairment Certificate

Form B-225 Special Permit Application and Impairment Certificate

November 30
00:00 -0001

Form B-225 Special Permit Application and Impairment Certificate

 

INSTRUCTIONS: CONNECTICUT SPECIAL PERMIT APPLICATION AND IMPAIRMENT CERTIFICATE (Form B-225)

 

 

To apply for a special parking permit related to a disability which impairs the ability to walk in Connecticut, a form B-225 should be used. This document can be obtained from the website of the government of Connecticut.

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 1: Section A should be completed by the applicant. Indicate with a check mark whether this is a new application, a replacement application or a renewal application.

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 2: Indicate with a check mark whether the applicant is disabled, blind, or an organization which transports blind or disabled people.

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 3: In the first blank box, enter the last name, first name and middle initial of the person who is blind or disabled,

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 4: In the second blank box, enter the applicant's date of birth.

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 5: In the third blank box, enter the applicant's driver's license or identification card number.

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 6: In the fourth blank box, enter the applicant's daytime telephone number.

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 7: In the fifth blank box, enter the applicant's street address, city, state and zip code.

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 8: In the sixth blank box, enter the applicant's mailing street address, city, state and zip code.

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 9: In the seventh blank box, the applicant should enter their signature.

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 10: In the eighth blank box, enter the date.

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 11: The form should then be submitted to your physician, APRN, physician's assistant, optometrist, ophthamologist, BESB or USVA for completion of Section B, which is a certification of the disability being claimed. They should provide all identifying information requested and indicate whether your condition is permanent or temporary.

 

Connecticut Special Permit Application And Impairment Certificate B-225 Step 12: Submit the completed form to the Connecticut Department of Vehicles via mail, fax, email or in person.

 

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