Form J-23B Vessel Copy Records Request
INSTRUCTIONS: CONNECTICUT VESSEL COPY RECORDS REQUEST (Form J-23B)
To request a copy of Connecticut vessel records, file a form J-23B. This document can be obtained from the website of the government of Connecticut.
Connecticut Vessel Copy Records Request J-23B Step 1: Check the first box if requesting a copy of the "vessel inquiry," or computer record.
Connecticut Vessel Copy Records Request J-23B Step 2: Check the second box if requesting a copy of the history of a specific boat.
Connecticut Vessel Copy Records Request J-23B Step 3: Check the third box if requesting copies of records related to all boats owned by a specific person.
Connecticut Vessel Copy Records Request J-23B Step 4: Check the fourth box if requesting a photocopy of a boat registration record.
Connecticut Vessel Copy Records Request J-23B Step 5: Check the fifth box if filing a miscellaneous request.
Connecticut Vessel Copy Records Request J-23B Step 6: Unless you are filing a miscellaneous request, you must complete sections 1 and 2. In section 1, enter the last name, first name and middle initial of the owner of each vessel in the first column. You may document up to three owners in this section.
Connecticut Vessel Copy Records Request J-23B Step 7: In the second column, enter the street address, city or town, state and zip code of each owner.
Connecticut Vessel Copy Records Request J-23B Step 8: In the first column of section 2, enter the hull number of each vessel. You may document up to three vessels in this section.
Connecticut Vessel Copy Records Request J-23B Step 9: In the second column, enter the Connecticut vessel number of each vessel.
Connecticut Vessel Copy Records Request J-23B Step 10: Section 3 is only to be completed if you are filing a miscellaneous request. Specify your request in the space provided.
Connecticut Vessel Copy Records Request J-23B Step 11: Enter the quantity of each record being sought, the unit price for each as documented at the top of the page, and the total amount owed.
Connecticut Vessel Copy Records Request J-23B Step 12: The bottom section of the form requires you to provide your name, street address, city or town, state and zip code.
Connecticut Vessel Copy Records Request J-23B Step 13: Submit a copy of your driver's license or other current photo identification along with your request.
Form SR-101 Disposition of Vehicle
INSTRUCTIONS: CONNECTICUT DISPOSITION OF VEHICLE (Form SR-101)
When a Connecticut motor vehicle has been sold, junked, repossessed, or donated to charity and no longer requires you to pay insurance coverage, you should file a form SR-101 to document disposition of the vehicle. This document can be obtained from the website of the government of Connecticut.
Connecticut Disposition Of Vehicle SR-101 Step 1: Enter your case number in the top lefthand corner.
Connecticut Disposition Of Vehicle SR-101 Step 2: Enter your name in the first blank box.
Connecticut Disposition Of Vehicle SR-101 Step 3: Enter your address in the second blank box.
Connecticut Disposition Of Vehicle SR-101 Step 4: Enter the make of the vehicle in the third blank box.
Connecticut Disposition Of Vehicle SR-101 Step 5: Enter the model of the vehicle in the fourth blank box.
Connecticut Disposition Of Vehicle SR-101 Step 6: Enter the year of the vehicle in the fifth blank box.
Connecticut Disposition Of Vehicle SR-101 Step 7: Enter the vehicle identification number in the sixth blank box.
Connecticut Disposition Of Vehicle SR-101 Step 8: Enter the plate number on the vehicle in the seventh blank box.
Connecticut Disposition Of Vehicle SR-101 Step 9: Indicate whether the plates were canceled by checking "yes" or "no" as applicable. If yes, enter the date of cancellation.
Connecticut Disposition Of Vehicle SR-101 Step 10: If the vehicle was sold, check the first box in the next section. Enter the date of sale and the name of the buyer.
Connecticut Disposition Of Vehicle SR-101 Step 11: If the vehicle was junked, check the second box. Enter the date on which it was junked and the name of the junkyard.
Connecticut Disposition Of Vehicle SR-101 Step 12: If the vehicle was repossessed, check the third box. Enter the date on which it was repossessed and the name of the lender.
Connecticut Disposition Of Vehicle SR-101 Step 13: If the vehicle was donated to charity, check the fourth box. Enter the date on which this occurred and the name of the charity.
Connecticut Disposition Of Vehicle SR-101 Step 14: In the next three blank boxes, enter the date the insurance was canceled on this vehicle, the name of the insurance company and the policy number.
Connecticut Disposition Of Vehicle SR-101 Step 15: Sign and date the form.
Form MCS-150CT Motor Carrier Identification Report
INSTRUCTIONS: CONNECTICUT MOTOR CARRIER IDENTIFICATION REPORT (Form MCS-150CT)
To apply for a new intrastate Department of Transportation number or to update your information, use a form MCS-150CT. This document can be obtained from the website of the government of Connecticut.
Connecticut Motor Carrier Identification Report MCS-150CT Step 1: Indicate with a check mark if you are filing a new application, a biennial update or an application documenting changes, an out of business notification, or a reapplication following the revocation of a new entrant.
Connecticut Motor Carrier Identification Report MCS-150CT Step 2: Enter the name of the motor carrier in box 1 and your trade or doing business as (dba) name in box 2.
Connecticut Motor Carrier Identification Report MCS-150CT Step 3: Enter your principal street address in box 3, city in box 4, your state or province in box 5, your zip code in box 6, and colonia (if operating in Mexico only) in box 7.
Connecticut Motor Carrier Identification Report MCS-150CT Step 4: Enter your mailing street address in box 8, city in box 9, state or province in box 10, zip code in box 11 and (only if operating in Mexico) colonia in box 12.
Connecticut Motor Carrier Identification Report MCS-150CT Step 5: Enter your principal business phone number in box 13, a principal contact cell phone number in box 14, and your principal business fax number in box 15.
Connecticut Motor Carrier Identification Report MCS-150CT Step 6: Enter your US Department of Transportation number in box 16, your MC or MX number in box 17, your DUN & Bradstreet number in box 18, and your IRS tax identification number in box 19.
Connecticut Motor Carrier Identification Report MCS-150CT Step 7: Enter your email address in box 20.
Connecticut Motor Carrier Identification Report MCS-150CT Step 8: Enter your carrier mileage and the year in box 21.
Connecticut Motor Carrier Identification Report MCS-150CT Step 9: Indicate your company operations by checking all applicable statements in box 22.
Connecticut Motor Carrier Identification Report MCS-150CT Step 10: Indicate your operation classification by checking all applicable statements in box 23.
Connecticut Motor Carrier Identification Report MCS-150CT Step 11: Complete questions 24 through 29 as instructed.
Connecticut Motor Carrier Identification Report MCS-150CT Step 12: Sign and date section 30, as well as providing your title.
Request for Disability Accommodation for Industrial Radiography Examination
INSTRUCTIONS: ALABAMA REQUEST FOR DISABILITY ACCOMMODATION FOR INDUSTRIAL RADIOGRAPHY EXAMINATION
Disabled Alabama residents who will be taking an industrial radiography examination use the form discussed in this article to request accommodations for this exam. This document can be obtained from the website maintained by the Alabama Department of Public Health.
Alabama Request For Disability Accommodation For Industrial Radiography Examination Step 1: In section 1, specify any disability-related needs that the Office of Radiation Control should be made aware of in order to provide appropriate accommodations for this examination.
Alabama Request For Disability Accommodation For Industrial Radiography Examination Step : In section 2, specify any prior accommodations you have received for this disability in an examination setting. If necessary, you may have a professional who is familiar with this disability complete this information. This professional can be a physician, psychologist, rehabilitation counselor or another type of related professional.
Alabama Request For Disability Accommodation For Industrial Radiography Examination Step 3: In section 3, if you have not received prior disability accommodations for an examination, you must consult with the appropriate professional who is familiar with your disability and is capable of advising you as to what type of accommodation is needed.
Alabama Request For Disability Accommodation For Industrial Radiography Examination Step 4: On the first blank line, enter your signature.
Alabama Request For Disability Accommodation For Industrial Radiography Examination Step 5: On the second blank line, enter the date.
Alabama Request For Disability Accommodation For Industrial Radiography Examination Step 6: On the third blank line, any professional who has helped you complete this form should enter their signature.
Alabama Request For Disability Accommodation For Industrial Radiography Examination Step 7: On the fourth blank line, any professional who has helped you complete this form should enter the date.
Alabama Request For Disability Accommodation For Industrial Radiography Examination Step 8: When filing this form, you must also attach a statement on letterhead stationery from a professional who is familiar with your disability, describing your disability and the type of accommodation needed.
Alabama Request For Disability Accommodation For Industrial Radiography Examination Step 9: To file the document, consult the separate instructional packet made available on the website of the Alabama Department of Public Health. This packet contains the address to which your exam application and all other documents must be mailed.
Form WCC10 Assessment Report 2012 For Insurance Companies, Self-Insurers, and Group Funds
INSTRUCTIONS: ALABAMA ASSESSMENT REPORT FOR INSURANCE COMPANIES, SELF-INSURERS AND GROUP FUNDS (WCC Form 10)
Alabama insurance companies, group funds and self-insured businesses must file a WCC Form 10 on an annual basis. This form can be obtained from the website of the Alabama Department of Labor.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 1: Enter your company name.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 2: Enter the name of a contact person.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 3: Enter your mailing and physical address.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 4: Enter your NCCI, FEIN, SI and GSI numbers.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 5: Enter your telephone number.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 6: Enter any subsidiaries if you are a self-insured company.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 7: Enter your total compensation paid.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 8: Enter your total medical costs paid.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 9: Enter your total attorney fees paid.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 10: Enter your total administrative expenses paid.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 11: Enter your total court settlements paid.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 12: Enter the total of all these expenses.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 13: Print your name where indicated.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 14: The bottom of the form must be completed in the presence of a notary public. Print your name again and enter your corporate title.
Alabama Assessment Report For Insurance Companies, Self-Insurers And Group Funds WCC Form 10 Step 15: Sign the form and give your title.