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In the vibrant state of Connecticut, navigating the roads without a valid driver's license poses a significant challenge, especially for individuals who rely on their vehicle to commute to work. Recognizing this necessity, the Connecticut Department of Motor Vehicles offers a lifeline in the form of the A-62 Application for Special Permit to Operate a Motor Vehicle to and from Work. Enacted with a firm commitment to aiding those whose licenses are under suspension, this form serves as a crucial tool for maintaining employment and ensuring economic stability during difficult times. The application process is marked by a detailed review of the applicant’s official driving record, underscoring the state’s dedication to road safety while providing a semblance of normalcy for those affected. With a non-refundable application fee of $100 and stringent criteria that applicants must meet—including a clear identification of work hours that do not exceed a 12-hour period in a day, proof of employment, and substantiation of hardship faced without the permit—the program epitomizes a balanced approach. Importantly, it stipulates that operating a motor vehicle under this permit outside of the authorized purposes and hours, or any attempt to alter or misuse the permit, exposes the individual to possible arrest, additional penalties, and criminal charges. Thus, the A-62 form embodies a vital resource for individuals striving to navigate the complexities of life without losing sight of their responsibilities and obligations.

Document Sample

STATE OF CONNECTICUT
DEPARTMENT OF MOTOR VEHICLES
DRIVER SERVICES DIVISION
60 STATE STREET, WETHERSFIELD, CT 06161-2530
TELEPHONE: (860) 263-5720 On The Web At ct.gov/dmv

APPLICATION FOR SPECIAL PERMIT TO

OPERATE A MOTOR VEHICLE TO AND FROM WORK

A-62 REV. 4-2010

INSTRUCTIONS:

1. Please print or type.

2. Multiple employment requires separate applications.

3. A $100.00 non-refundable application fee in the form of a check or money order payable to DMV must accompany each request for a permit.

Operation of motor vehicles requiring a CDL or used for Public Passenger Transportation is PROHIBITED under the Special Permit Program

YOUR OFFICIAL DRIVING RECORD WILL BE REVIEWED AS PART OF THIS APPLICATION.

NAME OF APPLICANT (Last, First, Middle)

DATE OF BIRTH

OPERATOR LICENSE NUMBER/STATE

SEX

M

F

MAILING ADDRESS

(Number and Street)

(City or Town)

(State)

(Zip Code)

 

 

 

 

 

RESIDENCE ADDRESS (If different)

(Number and Street)

(City or Town)

(State)

(Zip Code)

NAME OF EMPLOYER (If self-employed, include business name and legal proof of self-employment)

ADDRESS OF EMPLOYER

(Number and Street)

(City or Town)

(State)

(Zip Code)

OCCUPATION

HOME TELEPHONE NUMBER

( )

DAYS AND HOURS OF EMPLOYMENT (Specify A.M. or P.M.)

TO BE ISSUED A WORK PERMIT, YOUR SCHEDULE MUST BE CLEARLY IDENTIFIED, AND

MON.

TUE.

THU.

FRI.

SAT.

MAY NOT EXCEED A CONTINUOUS 12-HOUR PERIOD PER DAY.

IF YOU HAVE MORE THAN ONE PLACE OF

EMPLOYMENT, EACH EMPLOYER MUST

WED.SUN.

COMPLETE A SEPARATE APPLICATION.

What is the distance and the commuting time from your residence to your place of employment?

Is public transportation available

 

 

 

from your residence to your

YES

NO

 

place of employment?

 

 

 

What significant hardship(s) will you suffer without a Special Operator's Permit?

 

 

What efforts have you made to obtain other transportation?

INABILITY TO CONFIRM YOUR EMPLOYMENT MAY RESULT IN DENIAL OF YOUR SPECIAL OPERATOR'S PERMIT.

PRINTED NAME OF SUPERVISOR

SIGNATURE OF SUPERVISOR

X

PRINTED JOB TITLE OF SUPERVISOR

WORK TELEPHONE

( )

NOTICE:

OATH:

Your operator's license is under suspension. If you operate any vehicle outside of the authorized hours, you may be subject to arrest. If you operate a motor vehicle for a purpose not authorized by law, a police officer may make a report to the Commissioner of Motor Vehicles and you will be subject to a civil penalty of up to $500. If your operator's license is suspended for another reason while you are in possession of this permit, the permit is revoked, and if you thereafter operate a motor vehicle you will be subject to double the penalties imposed by law. If you alter or make improper use of the permit, you will be subject to criminal penalties.

I swear or affirm under penalty of false statement in accordance with Connecticut General Statute 53a-157, and subject to penalties for perjury for a deliberate false statement, that the above information and any attachment hereto is true and correct.

PRINTED NAME OF APPLICANT

SIGNATURE OF APPLICANT

DATE SIGNED

X

DMV USE ONLY

PERMIT:

APPROVED

DENIED

DATE PERMIT ISSUED

(If Approved)

PERMIT VALID UNTIL (If Approved)

REASON FOR DENIAL

DRIVING HISTORY

NO SIGNIFICANT HARDSHIP

INELIGIBLE

OTHER (Provide Details)

AUTHORIZED SIGNATURE (DMV)

X

PRINTED NAME

DATE SIGNED

Document Overview

Fact Description
Purpose The form is an application for a special permit to operate a motor vehicle to and from work in Connecticut.
Application Requirement Applicants must print or type the information requested on the form.
Multiple Employment Separate applications are required for each place of employment.
Fee A $100.00 non-refundable fee, payable to the DMV, must accompany the application.
Prohibitions Operating vehicles requiring a CDL or those used for Public Passenger Transportation is prohibited under this permit.
Employment Verification The applicant's employment will be verified as part of the application process.
Work Schedule The applicant's work schedule must be clearly identified and may not exceed a continuous 12-hour period per day.
Legal Acknowledgment Applicants swear or affirm under penalty of false statement, subject to penalties for perjury, that the information provided is true and correct.

Instructions on How to Fill Out Connecticut A 62

Filling out the Connecticut A-62 form is an essential step for individuals who are seeking permission to drive to and from work under certain conditions. This procedure is designed to ensure that those who need to operate a motor vehicle for employment purposes can do so legally and safely. The details provided in this application will be thoroughly reviewed, so it is important to follow the instructions carefully and provide accurate and complete information. Here's how to complete the application:

  1. Start by reading the entire form carefully to understand all the requirements and conditions associated with the application.
  2. Print or type your information into the form as handwritten responses can be hard to read and may lead to errors in processing your application.
  3. If you have multiple jobs, remember that you need to submit separate applications for each employment.
  4. Prepare a check or money order for $100.00, made payable to the DMV. This application fee is non-refundable, so double-check all your information before submission.
  5. Fill in your personal information, including your full name, date of birth, operator license number/state, and your sex.
  6. Provide both your mailing address and residence address (if different).
  7. Enter details about your employer, including the name, address, and telephone number. If you're self-employed, include your business name and provide legal proof of self-employment.
  8. Indicate your occupation, home telephone number, and the days and hours of your employment. Ensure that your work schedule is clearly defined and does not exceed a continuous 12-hour period per day.
  9. Detail the distance and commuting time from your home to your place of work, and specify whether public transportation is available.
  10. Explain the hardship you would suffer without a Special Operator’s Permit and describe the efforts you’ve made to obtain other forms of transportation.
  11. Have your supervisor complete the designated section of the application, including their printed name, signature, job title, and work phone number.
  12. Read the Notice and Oath section thoroughly. By signing the application, you affirm all the information provided is true to the best of your knowledge and understand the legal obligations and penalties for false statements.
  13. Finally, sign and date the application in the designated area at the bottom of the form.
  14. Submit the completed form and the application fee to the address provided by the Connecticut Department of Motor Vehicles. Be sure to keep a copy for your records.

Once submitted, your application will undergo a review process. Your official driving record will be considered as part of the application. Understanding the importance of this step and ensuring all information is accurate and complete increases your chances of a favorable outcome. Remember, safe and responsible driving is paramount, and adhering to the conditions of the Special Permit, if granted, is crucial.

More About Connecticut A 62

  1. What is the A-62 form used for in Connecticut?

    The A-62 form in Connecticut is an application for a special permit that allows individuals whose driver's licenses are under suspension to operate a motor vehicle specifically for commuting to and from work. This special permit is part of an effort to mitigate the hardship of not being able to drive due to a suspended license, allowing individuals to maintain employment. It's important to note that this permit comes with strict limitations, including the prohibition of operating commercial vehicles or those used for public passenger transportation under this program.

  2. How does one apply for this special work permit, and what is the associated fee?

    To apply for the special work permit using the A-62 form, an individual must fill out the application with accurate details regarding their employment, including working hours and employer information. If the applicant has multiple jobs, a separate application is required for each place of employment. A non-refundable application fee of $100.00, payable by check or money order to the DMV, must accompany the submitted form. It's also crucial that the applicant's official driving record will be reviewed as part of the application process to ensure eligibility.

  3. Are there restrictions on the use of the special work permit?

    Yes, there are several restrictions associated with the use of the special work permit. Firstly, the permit strictly limits the holder to operate a motor vehicle solely for the purpose of commuting to and from work. The work schedule must be explicitly defined and may not exceed a continuous 12-hour period per day. Additionally, the use of the permit is not allowed for the operation of vehicles requiring a commercial driver's license (CDL) or those used for public passenger transportation. Any misuse of the permit, such as operating a vehicle outside of the authorized hours or for unauthorized purposes, may result in civil or criminal penalties, including fines and the revocation of the permit.

  4. What happens if an individual's circumstances change after receiving the special work permit?

    If there is a change in an individual's circumstances after receiving the special work permit, such as a change in employment or additional reasons for suspension, it is imperative to notify the Department of Motor Vehicles (DMV). The permit is subject to revocation if the individual's operator's license is suspended for another reason while they are in possession of this permit. Additionally, altering or improperly using the permit will prompt legal action, subjecting the holder to criminal penalties. It's also worth noting that operating a vehicle outside the authorized parameters of the permit can lead to arrest and further penalties.

Common mistakes

Filling out the Connecticut A-62 form, an application for a special permit to operate a motor vehicle to and from work, can be a straightforward process, but even small mistakes can lead to delays or denials. By avoiding common pitfalls, applicants can streamline the process and increase their chances of approval. Here are nine mistakes often made and how to steer clear of them.

  1. Not printing or typing clearly: The form instructs applicants to print or type. Unclear handwriting can lead to misinterpretation of crucial information, such as names, addresses, or license numbers, which can delay processing.
  2. Failing to provide separate applications for multiple employers: If you have more than one job, you need to fill out a separate application for each employer. Combining them into one can invalidate your application.
  3. Omitting the application fee: A $100.00 non-refundable application fee must accompany your request. Forgetting to include the fee, or providing it in an unacceptable form, is a common misstep. The form requires details about your employer. If you're self-employed, this includes your business name and legal proof of self-employment. Missing or vague information may result in application denial.
  4. Ignoring the schedule requirement: Your work schedule must be clearly identified and cannot exceed a continuous 12-hour period per day. Overlooking or inaccurately detailing this section might cause the DMV to deny the application.
  5. Assuming availability of public transport doesn't matter: Whether or not public transportation is available from your residence to your place of employment is a critical component of the form. Answering incorrectly or not at all can impact the decision-making process.
  6. Not detailing the hardship suffered: The application asks what significant hardship you will suffer without the Special Operator's Permit. A lack of detailed explanation may lead to a rejection.
  7. Forgetting to document efforts to obtain other transportation: If you do not include the efforts made to explore other modes of transportation, it might appear to the reviewing officer that you have not fully considered alternatives to receiving a permit.
  8. Overlooking supervisor’s section: The supervisor’s printed name, signature, job title, and work telephone number are crucial for employment verification. Incomplete or missing supervisor information can directly result in an unvalidated employment claim.

Avoiding these errors can substantially improve the chances of your application being approved. Paying close attention to every section, following instructions to the letter, and ensuring all information is accurate and verifiable are key steps to success. When in doubt, reviewing the form multiple times or seeking advice can prevent common mistakes and get you closer to obtaining your special operator's permit.

Documents used along the form

When navigating the complexities of motor vehicle regulations in Connecticut, particularly in relation to obtaining a Special Permit to Operate a Motor Vehicle to and from Work using the A-62 form, applicants may find themselves dealing with an array of supplementary forms and documents. The journey from application to approval is seldom solitary; it usually requires the assembly of multiple documents to validate the application's claims and to comply fully with the Department of Motor Vehicles' (DMV) requirements. Below is a compendium of additional forms and documents typically associated with or needed to complete the A-62 form submission process.

  1. Proof of Employment Verification: A document provided by the employer, confirming the employment details including the applicant's occupation, days, and hours of work. This serves as a crucial piece of evidence for the necessity of a special operator permit.
  2. Driving Record Abstract: An official document summarizing an individual's driving history, which can include information about traffic violations, accidents, suspensions, and the status of the driver's license. It's used to assess eligibility for the permit.
  3. Proof of Identity and Age: Typical documents include a birth certificate, passport, or state-issued ID that verifies the applicant's identity and date of birth, ensuring they meet the minimum requirements for the permit application.
  4. Connecticut Vehicle Registration: Evidence that the vehicle to be used is registered under Connecticut law, connecting the vehicle legally to the applicant for the purpose of the permit.
  5. Proof of Insurance: A document from the insurance provider listing the coverage details of the vehicle the applicant intends to use, proving compliance with Connecticut's minimum insurance requirements.
  6. Special Permit Program Terms and Conditions Acknowledgment Form: A form outlining the rules and limits of the Special Permit Program, which the applicant must sign, acknowledging understanding and agreement to these terms.
  7. Public Transportation Accessibility Statement: If relevant, a document or detailed explanation concerning the availability of public transport from the applicant's residence to their place of work, supporting the claim of significant hardship without a special permit.
  8. Payment Receipt for Non-refundable Application Fee: A receipt proving the applicant has paid the necessary application fee, which is a prerequisite for processing the permit request.
  9. Connecticut Emissions Testing Report: For some applicants, particularly those using older vehicles, proof of a current and successful emissions test may be required to ensure the vehicle meets environmental safety standards.
  10. Medical Evaluation Form (if applicable): In some cases, a form completed by a medical professional may be necessary to confirm the applicant's ability to safely operate a vehicle, relevant to the special considerations of their permit.

While completing the Connecticut A-62 form, applicants should meticulously gather and review all required supplementary documents and forms to ensure a smooth and successful application process. Each of these documents plays an integral role in illustrating the applicant's need and eligibility for a special permit, providing the DMV with a comprehensive view of the applicant's situation. As with any legal process, attention to detail and adherence to the specific requirements can significantly affect the outcome.

Similar forms

The Connecticut A-62 form, which outlines an application for a special permit to operate a motor vehicle to and from work, shares similarities with several other forms and documents, each designed for specific driving or vehicle-related circumstances.

Driver's License Application: The A-62 form is similar to a standard driver's license application in that both require personal information from the applicant, such as name, address, and date of birth. Additionally, both forms necessitate details regarding the applicant's driving history and the status of their current driver’s license. Where they diverge is in their specific purposes: while a driver's license application seeks to grant the applicant the ability to drive legally in general, the A-62 form specifically addresses the need to drive for employment purposes under a special permit, particularly when the applicant's regular driver's license is suspended.

Hardship License Application: Another document that bears resemblance to the A-62 form is a hardship license application, employed in many states for drivers whose licenses have been suspended. Like the Connecticut A-62, hardship license applications often require detailed explanations of the applicant's need to drive, such as employment, education, or medical reasons. Both forms scrutinize the applicant's past driving record and other certifications to justify the issuance of a limited-use license. The key similarity lies in their purpose to alleviate undue hardship caused by the inability to legally drive, though the criteria and specifics may vary from one state to another.

Employment Verification Form: While primarily centered on driving permissions, the A-62 form also shares commonalities with employment verification forms due to its requirement for employer information, including the employer's name, address, and verification of employment status. These forms both serve to confirm the applicant's claimed employment status and schedule, critical in the A-62's context for demonstrating a work-related need to drive. However, the A-62 uniquely combines aspects of driving legality with employment verification, underscoring the specialized nature of this permit application.

Dos and Don'ts

When filling out the Connecticut A-62 form, an application for a special permit to operate a motor vehicle to and from work, there are specific dos and don'ts that applicants should adhere to. The following list outlines essential guidelines to ensure the process is completed effectively and to increase the likelihood of approval.

  • Do ensure that all information provided is accurate and truthful. The integrity of the application is paramount, and misinformation can lead to denial or legal consequences.
  • Don't leave any required fields blank. Incomplete forms may be considered invalid, delaying the process or resulting in denial. If a section does not apply, consider entering "N/A" for clarity.
  • Do print or type in clear, legible handwriting. This prevents misunderstandings and processing errors.
  • Don't use a personal check for the application fee; ensure the $100.00 non-refundable fee is submitted via check or money order payable to DMV, as specified.
  • Do include all necessary documentation, such as proof of employment and any legal proof of self-employment if applicable. This substantiates the application and clarifies your employment status.
  • Don't forget to outline the significant hardship(s) you will suffer without the Special Operator's Permit. Clearly articulate the impact to highlight the necessity of the permit for your situation.
  • Do indicate the days and hours of employment accurately. Your schedule must be clearly identified and should not exceed a continuous 12-hour period per day. This information is crucial for the permit's validity.
  • Don't operate a motor vehicle outside of the authorized hours once granted the permit. Unauthorized use may lead to arrest, additional penalties, or revocation of the permit.
  • Do sign the oath section at the end of the application, thereby affirming that all the provided information and attachments are true and correct. This act is legally binding and holds you accountable for the accuracy of the submitted details.

Adhering to these guidelines when completing the Connecticut A-62 form is essential for a smooth process. Remember, the goal of this application is to obtain a legal permit that facilitates your transportation to work during a suspension period, necessitating a careful and thorough approach.

Misconceptions

When discussing the Connecticut Department of Motor Vehicles (DMV) A-62 form, entitled “Application for Special Permit to Operate a Motor Vehicle to and from Work,” several misconceptions frequently arise among applicants and the general public. These misunderstandings can lead to confusion about who is eligible for the permit, the permit's limitations, and the application process. Here are six common misconceptions clarified:

  • The A-62 form is for first-time drivers. In reality, this application is specifically designed for individuals whose operator's license has been suspended. It seeks to provide a legal avenue for them to drive to and from their place of employment under strict conditions, not to facilitate the licensing process for new drivers.
  • There is no fee associated with the application. Contrary to this belief, the application must be accompanied by a $100.00 non-refundable application fee. This fee is mandatory, and the application is considered incomplete without it. Payment must be made via check or money order payable to the DMV.
  • The permit allows for unlimited driving as long as it is work-related. The scope of this special permit is significantly limited. It allows for operation of a motor vehicle only for commuting directly to and from work. The driving schedule must not exceed a continuous 12-hour period per day, and any other use is strictly prohibited.
  • Public transportation availability disqualifies applicants. Although the application asks if public transportation is available, this is just one factor considered in evaluating significant hardship. The availability of public transportation does not automatically disqualify an applicant from being granted the permit.
  • One application can cover multiple jobs. If an individual holds more than one job, they must file a separate A-62 application for each place of employment. The form requires specifics about employment hours and location for each job to determine the necessity and scope of the permit.
  • The permit is instantly approved once applied for. The process involves a thorough review, including the assessment of the applicant’s official driving record and the verification of employment details provided on the form. Approval is at the discretion of the DMV, and not all applicants will receive a permit. Factors such as failure to confirm employment or lack of significant hardship can result in denial.

Understanding the specific requirements and limitations of the Connecticut A-62 form can significantly improve the application process for individuals seeking a special permit to drive to and from work while their license is suspended. It's important for applicants to carefully review all instructions and accurately fulfill each condition to increase their chances of obtaining this special operator's permit.

Key takeaways

Filling out the Connecticut A-62 form accurately is essential for those who need a special permit to operate a motor vehicle to and from work while their operator's license is suspended. Understanding the requirements and restrictions of this permit can help applicants navigate the process successfully. Here are key takeaways to keep in mind:

  • Application Accuracy: It’s crucial to print or type information clearly on the application to avoid misunderstandings or processing delays.
  • Separate Applications for Multiple Jobs: If you have more than one place of employment, you need to fill out a separate application for each job.
  • Non-refundable Fee: Each application must be accompanied by a $100.00 non-refundable application fee, payable to the DMV via check or money order.
  • Prohibited Vehicle Operations: The special permit does not allow the operation of motor vehicles that require a Commercial Driver's License (CDL) or those used for Public Passenger Transportation.
  • Employment Verification: Applicants must provide verifiable employment information. If employment cannot be confirmed, the application for a special operator's permit may be denied.
  • Clear Schedule Requirement: The application requires a clearly identified work schedule that does not exceed a continuous 12-hour period per day.
  • Public Transportation Inquiry: Applicants must state whether public transportation is available from their residence to their place of employment and describe any significant hardship they would suffer without a Special Operator's Permit.
  • Legal and Penalty Acknowledgement: Applicants acknowledge under oath that if they operate a vehicle outside of the authorized hours or for purposes not allowed by law, they are subject to arrest, civil penalties of up to $500, or even criminal penalties for altering or making improper use of the permit. Additionally, the permit will be revoked if the applicant’s operator's license is suspended for another reason during the permit’s validity.

Understanding these key aspects of the Connecticut A-62 form not only facilitates a smoother application process but also underscores the responsibilities and limitations associated with a Special Permit to Operate a Motor Vehicle To and From Work. Compliance with these guidelines ensures that applicants can retain their mobility for employment purposes, within the bounds of the law.

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