Structure
The Connecticut H 109 form serves as a crucial document for municipalities in the state when dealing with abandoned motor vehicles. This form outlines specific procedures that must be followed when a vehicle is deemed abandoned, particularly those valued at $500 or less, which are unusable and lack a valid marker plate. The form requires municipalities to complete Section A upon taking possession of such vehicles, detailing information such as the vehicle's make, model, and identification number, as well as the circumstances surrounding its abandonment. It is imperative that the original form be submitted to the Department of Motor Vehicles within 48 hours of custody. Additionally, Section B must be filled out when ownership of the abandoned vehicle is transferred to a junkyard, ensuring that the new owner receives the necessary documentation in lieu of a vehicle title. The form emphasizes the importance of compliance with Connecticut General Statutes and includes certification by a municipal official to validate the process. By adhering to these guidelines, municipalities can effectively manage abandoned vehicles while maintaining accurate records and ensuring proper transfer of ownership.
Connecticut H 109 Example
MUNICIPALITY REPORT OF ABANDONED MOTOR VEHICLE |
STATE OF CONNECTICUT |
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DEPARTMENT OF MOTOR VEHICLES |
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TITLE SECTION |
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INSTRUCTIONS |
60 STATE STREET, WETHERSFIELD, CT 06161 |
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On The Web At ct.gov/dmv |
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1.Complete SECTION A for each abandoned motor vehicle which is determined to be: (a) valued at $500.00 or less; (b) unusable as a motor vehicle; and (c) without a valid marker plate (C.G.S.
2.Submit original form to the Department of Motor Vehicles within 48 HOURS of the time the motor vehicle is taken into custody.
3.Retain a copy and complete SECTION B when vehicle ownership is transferred. Submit copy to transferee in lieu of a vehicle title.
TO: DEPARTMENT OF MOTOR VEHICLES, TITLE SECTION, 60 STATE STREET, WETHERSFIELD, CT 06161
SECTION A - TO BE COMPLETED WHEN MUNICIPALITY TAKES POSSESSION OF MOTOR VEHICLES
NAME OF MUNICIPALITY (in which title is vested)
DATE AND TIME VEHICLE TAKEN INTO CUSTODY
NAME OF OFFICER OR INSPECTOR (who determines vehicle meets C.G.S.
BADGE NUMBER
VEHICLE
INFORMATION
YEAR |
MAKE/MODEL |
VEHICLE IDENTIFICATION NUMBER |
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LOCATION VEHICLE ABANDONED |
(No. & Street) |
(City or Town) |
BUSINESS NAME & ADDRESS OF TOWER
AMOUNT OF CHARGE IMPOSED BY TOWER
$
I hereby certify the above abandoned vehicle meets the specifications of C.G.S.
DEPARTMENT NAME
AUTHORIZED SIGNATURE OF MUNICIPAL OFFICIAL
X
DATE SIGNED
SECTION B - TO BE COMPLETED WHEN MUNICIPALITY TRANSFERS OWNERSHIP OF MOTOR VEHICLE TO JUNKYARD
TRANSFEREE INFORMATION
NAME
ADDRESS |
(No. & Street) |
(City or Town) |
(State) |
(Zip Code) |
DEPARTMENT NAME
AUTHORIZED SIGNATURE OF MUNICIPAL OFFICIAL
X
DATE SIGNED
Document Specifications
| Fact Name | Details |
|---|---|
| Form Title | The official title of the form is the "Municipality Report of Abandoned Motor Vehicle." This indicates its purpose in documenting abandoned vehicles. |
| Governing Law | This form is governed by Connecticut General Statutes (C.G.S. §14-150(d)), which outlines the criteria for determining abandoned vehicles. |
| Submission Timeline | Municipalities must submit the completed form to the Department of Motor Vehicles within 48 hours of taking the vehicle into custody. |
| Section A Requirements | Section A must be completed for vehicles valued at $500 or less, deemed unusable, and lacking a valid marker plate. |
| Section B Purpose | Section B is used when the municipality transfers ownership of the abandoned vehicle to a junkyard, ensuring proper documentation of the transfer. |
| Contact Information | The form must be sent to the Department of Motor Vehicles at 60 State Street, Wethersfield, CT 06161. |
| Signature Requirement | An authorized municipal official must sign the form, certifying that the vehicle meets the specifications of C.G.S. §14-150(d). |
| Vehicle Information Needed | Key vehicle details such as year, make/model, vehicle identification number, and location of abandonment must be provided. |
| Fees Imposed | The form allows for the documentation of any charges imposed by the towing service, ensuring transparency in the process. |
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