Form H-13 - Official Registration Of A Motor Vehicle And Application For Certificate Of Title

Download a blank fillable Form H-13 - Official Registration Of A Motor Vehicle And Application For Certificate Of Title in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form H-13 - Official Registration Of A Motor Vehicle And Application For Certificate Of Title with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

OFFICIAL REGISTRATION

VOID UNLESS

OF A MOTOR VEHICLE AND APPLICATION

VALIDATED

FOR CERTIFICATE OF TITLE

HERE BY

H-13 REV. 2-2013

CONNECTICUT

DMV

STATE OF CONNECTICUT

DEPARTMENT OF MOTOR VEHICLES

60 STATE STREET, WETHERSFIELD, CT 06161

INSTRUCTIONS:

(1)

Please print using a black or blue pen.

(2)

If required, TITLE must accompany this

application.

OWNER'S NAME (Last, First, Middle Initial)

OWNER'S SEX

OWNER'S BIRTHDATE

OWNER'S LICENSE NO. OR ID

STATE

MAILING ADDRESS

(Number and Street)

CT RESIDENT

RESIDENT ADDRESS (If Different from Mailing Address - PO Box is NOT

acceptable)

YES

(City or Town)

(State)

(Zip Code)

IF CO-OWNERSHIP

COMMON/AND - Requires ALL

JOINT/OR - Requires ONLY ONE

OWNER

signatures to transfer ownership

signature to transfer ownership

CO-OWNER'S NAME (If any)

CO-OWNER'S SEX

CO-OWNER'S BIRTHDATE CO-OWNER'S LICENSE NO. OR ID

STATE

IS OWNER A BUSINESS

INITIALS

I certify the following: (1) I am the owner of five (5) or more vehicles that are registered in my name, either individually or

YES

jointly with other named owners; (2) I do not have a license to sell, repair, recycle, lease or rent motor vehicles.

CT TOWN & STREET ADDRESS WHERE VEHICLE IN THE NORMAL COURSE OF OPERATION MOST FREQUENTLY LEAVES FROM, RETURNS TO OR REMAINS (For property tax )

NAME OF LESSEE (Person to whom or company to which vehicle is leased)

LESSEE OPERATOR LICENSE NO.

CONNECTICUT LEASING LICENSE NO.

IF LEASED

ADDRESS OF LESSEE (P.O. Box is Not Acceptable)

(Number and Street)

(City or Town)

(State)

(Zip Code)

VEHICLE

VEHICLE I.D. NUMBER

YEAR

MAKE

MODEL NAME OR NO.

BODY STYLE (4-Dr. Sedan, etc.)

VEHICLE

REGISTRATION

COLOR (Maximum of Two)

ODOMETER READING (Mileage)

COMMERCIAL USE

FUEL TYPE (Gas, Diesel, etc.)

CYLINDERS

NO. OF WHEELS

NEW OR USED

(Please complete

in full)

NEW

USED

YES

SEAT CAPACITY NO. STANDEES

CARRY SCHOOL CHILDREN?

COM. CARRIER-US DOT NO. (If assigned)

LIGHT WEIGHT (Wt. empty)

NO. AXLES

COMPLETE FOR

APPLICABLE VEHICLE

YES

IF OTHER

(Buses, Trucks)

THAN

GROSS WEIGHT (Light wt. + max load)

GROSS VEHICLE WT. RATING

HAZARDOUS MATERIAL

INTERSTATE COMMERCE

TRAILERS

- Rear lights required. Brakes required if

PASSENGER

3,000 lbs. or more GVWR. Length of vehicle & trailer

STYLE VEHICLE

YES

combined must be in accordance with CGS 14-262.

LIEN-HOLDER FINANCING VEHICLE PURCHASE FOR CURRENT OWNER

DATE OF LIEN

SECOND LIEN-HOLDER (If Any)

DATE OF SECOND LIEN

LIEN-HOLDER

(If vehicle

ADDRESS OF LIEN-HOLDER

ADDRESS OF SECOND LIEN-HOLDER

purchase was

financed)

INSURANCE COMPANY NAME (Not Agent)

AUTOMOBILE INSURANCE POLICY NO.

AUTO

INSURANCE

NAME OF SELLER(S) (If 2 owners, include both names)

DATE VEHICLE PURCHASED

SELLER(S)

SELLER'S ADDRESS

PURCHASE PRICE (Bill of Sale required)

READ REVERSE SIDE OF THIS

IF TAX

CODE NO.

EXEMPTION INFORMATION (If leased vehicle lessor tax number if applicable)

FORM, SPECIFY CODE AND ANY

EXEMPTION IS

TAX EXEMPTION

ADDITIONAL INFORMATION.

CLAIMED

IDENTIFICATION NUMBER OF TRADED-IN VEHICLE

YEAR

MAKE

CT DEALER LIC. NO.

CT SALES TAX PERMIT NO.

DEALER

TOTAL SALES PRICE

TRADE-IN ALLOWANCE

NET SALES PRICE

STATE TAX COLLECTED

DEALER SIGNATURE

DATE SIGNED

TRANSACTION

The undersigned certifies that there are no liens on this vehicle except those specified above, the insurance required by Connecticut law is in effect and will be maintained during this registration period, all property taxes due any CT

Taxing Authority for any vehicle previously registered in my/our name(s) have been paid, if other than Passenger registration this vehicle is registered in accordance with Manufacturer's Maximum Gross Vehicle Weight Rating. The

information provided to the Commissioner of Motor Vehicles herein is subscribed by me, the undersigned, under penalty of false statement, in accordance with the provisions of Section 14-110 and 53a-157b of the Connecticut

General Statutes. I understand that if I make a statement which I do not believe to be true, with the intent to mislead the Commissioner, I will be subject to prosecution under the above-cited laws.

OWNER'S

SIGNATURE

OWNER'S SIGNATURE

DATE SIGNED

CO-OWNER'S SIGNATURE

DATE SIGNED

DMV OFFICE USE ONLY

C.C.

S.C.

TYPE OF REGISTRATION

MARKER PLATE NO.

new issue