INSTRUCTIONS: CONNECTICUT EXAMINATION TO DETERMINE PHYSICAL CONDITION OF DRIVER (Form R-323)

In order to receive a license to operate as a commercial vehicle operator in Connecticut, you must be certified as in shape to do so. This examination is documented using a form R-323, which can be obtained from the website of the government of Connecticut.

Connecticut Examination To Determine Physical Condition Of Driver R-323 Step 1: The first section concerns the driver and should be completed by them. In the first three blank boxes, enter your name, Social Security number and birthdate.

Connecticut Examination To Determine Physical Condition Of Driver R-323 Step 2: Indicate your sex with a check mark in the fourth blank box.

Connecticut Examination To Determine Physical Condition Of Driver R-323 Step 3: Indicate whether you are applying for a new certification, a recertification or a follow-up with a check mark in the fifth blank box.

Connecticut Examination To Determine Physical Condition Of Driver R-323 Step 4: Enter the date of the exam in the sixth blank box.

Connecticut Examination To Determine Physical Condition Of Driver R-323 Step 5: Enter your street address, city or town, state and zip code in the seventh blank box.

Connecticut Examination To Determine Physical Condition Of Driver R-323 Step 6: Enter your work telephone number in the eighth blank box and your home telephone number in the ninth blank box.

Connecticut Examination To Determine Physical Condition Of Driver R-323 Step 7: Enter your driver's license number in the tenth blank box. Indicate your license cass with a check mark in the eleventh blank box.

Connecticut Examination To Determine Physical Condition Of Driver R-323 Step 8: Enter the state that issued your driver's license in the twelfth blank box.

Connecticut Examination To Determine Physical Condition Of Driver R-323 Step 9: Section 2 documents the driver's health history. For each condition, indicate whether it is in your history by checking "Yes" or "No" as applicable. For all conditions to which you answered "Yes," provide the onset date, diagnosis, the treating physician's name and address, any current limitations and all medications used recently or currently.

Connecticut Examination To Determine Physical Condition Of Driver R-323 Step 10: Sections 3 through 7 will be completed by the medical examiner, who will sign and date the bottom of the second page.

INSTRUCTIONS: CONNECTICUT MUNICIPALITY REPORT OF ABANDONED MOTOR VEHICLE (Form H-109)

When a Connecticut municipality takes possession of an abandoned motor vehicle whose value is $50,000 or less, which is unusable and which does not have a valid marker plate, this is documented using a form H-109. This document can be obtained from the website of the government of the state of Connecticut.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 1: Section A should be completed when possession of the motor vehicle is taken by the municipality. Enter the name of the municipality in the first blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 2: Enter the date and time the vehicle was taken into custody in the second blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 3: Enter the name of the officer or inspector who evaluated the vehicle in the third blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 4: Enter the badge number of the officer or inspector in the fourth blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 5: Enter the year of the vehicle in the fifth blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 6: Enter the make of the vehicle in the sixth blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 7: Enter the vehicle identification number in the seventh blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 8: Enter the location where the abandoned vehicle was found in the eighth blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 9: Enter the business name and address of the tower in the ninth blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 10: Enter the amount charged by the tower in the tenth blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 11: Enter the department name in the eleventh blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 12: The authorized municipal official should enter their signature in the twelfth blank box and the date in the thirteenth blank box.

Connecticut Municipality Report Of Abandoned Motor Vehicle H-109 Step 13: Section B should be completed when the vehicle has had its ownership transferred to a junkyard.