Home Other Form P-248 Ignition Interlock Device Installation Authorization Form

Form P-248 Ignition Interlock Device Installation Authorization Form

Form P-248 Ignition Interlock Device Installation Authorization Form

 

INSTRUCTIONS: CONNECTICUT IGNITION INTERLOCK DEVICE INSTALLATION AUTHORIZATION FORM (Form P-248)

 

 

Connecticut drivers use a form P-248 to give their consent to the installation of an ignition interlock device. This document can be obtained from the website of the government of Connecticut. Note that a separate form must be submitted for each vehicle that will be operated under this program which is not owned by the participant.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 1: Enter the name of the vehicle owner in the first blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 2: Enter the street address of the vehicle owner in the second blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 3: Enter the city, state and zip code of the vehicle owner in the third blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 4: Enter the vehicle year in the fourth blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 5: Enter the vehicle make in the fifth blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 6: Enter the vehicle color in the sixth blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 7: Enter the vehicle model in the seventh blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 8: Enter the vehicle registration plate number in the eighth blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 9: Enter the name of the vehicle operator in the ninth blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 10: Enter the date of birth of the vehicle operator in the tenth blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 11: Enter the street address of the vehicle operator in the eleventh blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 12: Enter the city, state and zip code of the vehicle operator in the twelfth blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 13: Enter the printed name of the vehicle owner in the thirteenth blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 14: Enter the signature of the vehicle owner in the fourteenth blank box.

 

Connecticut Ignition Interlock Device Installation Authorization Form P-248 Step 15: Enter the date in the fifteenth blank box.

 

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