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The H 108 Connecticut form serves as a crucial tool for vehicle owners in the state who find themselves in the unfortunate situation of having their vehicle stolen. This report must be filed with the local or state police department where the theft occurred, as mandated by Connecticut General Statutes. Completing the H 108 form not only initiates the official documentation of the theft but is also a necessary step for insurance claims related to the stolen vehicle. The form collects essential information, including the vehicle's make, model, and identification number, as well as details about the theft itself, such as the time and location of the incident. Additionally, it requires the owner's contact information and insurance details, ensuring that all relevant parties are informed and can take appropriate action. Filing this report accurately and promptly is vital, as providing false information can lead to significant penalties. Understanding the importance of the H 108 form can empower vehicle owners to navigate the aftermath of a theft more effectively, safeguarding their rights and interests during a challenging time.

H 108 Connecticut Example

STOLEN VEHICLE REPORT

STATE OF CONNECTICUT

H-108 REV. 8-2001

DEPARTMENT OF MOTOR VEHICLES

 

On The Web At http://dmvct.org

INSTRUCTIONS: The owner of any motor vehicle stolen in this state must make a report in writing to the office of the local or State Police in the municipality in which the theft occurred. (C.G.S. 14-151a(a)). The filing of this report in accordance with the above, is required by C.G.S. 14-151a(b) prior to settlement of any insurance claim.

NOTICE: A person who knowingly makes a false report of the theft of a motor vehicle to a Police Officer shall be fined five hundred dollars or imprisoned for not more than six months or both in accordance with Section 14-198 of the Connecticut General Statutes.

P.D.

USE

ONLY

CASE NUMBER

NCIC NUMBER

I hereby report to the following Police Department

NAME OF POLICE DEPARTMENT

 

DATE REPORTED

 

 

 

that the vehicle described below was stolen.

 

 

 

 

YEAR

MAKE

MODEL

BODY STYLE

COLOR(S)

 

 

 

 

 

 

VEHICLE

MARKER PLATE NUMBER

 

VEHICLE REGISTERED? IF YES, IN WHAT STATE? VEHICLE IDENTIFICATION NUMBER

 

 

 

 

INFORMATION

 

 

 

 

 

NO

YES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ESTIMATED VALUE OF VEHICLE

WERE DOORS LOCKED?

WERE KEYS IN VEHICLE?

 

NAME OF INSURANCE COMPANY

 

 

$

 

 

 

 

 

YES

 

 

NO

 

 

YES

NO

 

 

 

 

 

 

 

 

NAME OF OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TELEPHONE NUMBER

OWNER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WILL OWNER OR PERSON IN CUSTODY OF VEHICLE BE AVAILABLE FOR COURT?

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE VEHICLE STOLEN

 

DAY OF WEEK

 

TIME

 

 

 

 

LOCATION STOLEN FROM (Street,, etc.)

 

INCIDENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A.M.

P.M.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION REPORTED STOLEN BY (Name)

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

TELEPHONE NUMBER

 

SIGNATURE (Person filling out report)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE SIGNED

SIGNATURE X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DO NOT WRITE BELOW THIS LINE - POLICE DEPARTMENT USE ONLY

 

 

REPORT TAKEN BY (Name of Officer)

 

BADGE NUMBER

 

POLICE DEPARTMENT

POLICE DEPARTMENT NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Local

 

State

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE REPORT FILED

 

TIME FILED (Military)

 

NCIC ENTERED

 

TIME ENTERED (Military)

NCIC OPERATOR

 

 

 

OFFICER'S

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDITIONAL INFORMATION (Continue on back if necessary)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REPORT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF RECOVERY

 

TIME (Military)

 

RECOVERY LOCATION

 

 

 

 

 

 

 

 

NAME OF RECOVERY OFFICER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WAS VEHICLE TOWED?

 

IF YES, BY WHOM (Name and address)

 

 

 

 

 

 

 

 

WHO AUTHORIZED TOW?

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WAS ARREST MADE?

 

WAS OWNER NOTIFIED?

DATE OWNER NOTIFIED

TIME NOTIFIED (Military)

 

NOTIFYING OFFICER (Name)

 

 

RECOVERY

YES

NO

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REPORT

WAS NCIC CANCELED?

 

DATE CANCELED

 

 

TIME CANCELED (Military)

NCIC OPERATOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME AND ADDRESS OF PERSON CLAIMING VEHICLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LICENSE NUMBER (State and Number)

 

 

 

 

 

SIGNATURE OF PERSON CLAIMING VEHICLE

 

DATE SIGNED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PARTS

MISSING

 

DAMAGED

SECTIONS

MISSING

DAMAGED

LOCKS

 

DAMAGED

BURNED

YES

NO

 

 

(x)

 

 

(x)

 

 

 

 

 

(x)

 

(x)

 

 

 

 

(x)

 

 

(x)

(x)

 

TIRES

 

 

 

 

 

 

 

FRONT

 

 

 

 

 

 

 

IGNITION

 

 

 

MOTOR COMP.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ENGINE

 

 

 

 

 

 

 

R. SIDE

 

 

 

 

 

 

 

DOOR

 

 

 

PASS. COMP.

 

 

CONDITION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TRANS.

 

 

 

 

 

 

 

L. SIDE

 

 

 

 

 

 

 

TRUNK

 

 

 

TRUNK COMP.

 

 

ON

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INS. PANEL

 

 

 

 

 

 

 

REAR

 

 

 

 

 

 

 

GAS CAP

 

 

 

TOTAL

 

 

RECOVERY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEATS

 

 

 

 

 

 

 

HOOD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RADIO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRE DEPT. RESPONSE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVEABLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DISTRIBUTION: Part 1- State or Local Police Part 2 - Individual Making Complaint

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Document Specifications

Fact Name Description
Form Title H-108 Stolen Vehicle Report
Governing Law C.G.S. 14-151a(a) requires vehicle owners to report stolen vehicles to local or State Police.
Insurance Requirement Filing the report is necessary under C.G.S. 14-151a(b) before settling any insurance claims.
False Report Penalty Making a false report can result in a fine of $500 or imprisonment for up to six months (C.G.S. 14-198).
Reporting Authority The report must be submitted to the local or State Police department where the theft occurred.
Vehicle Identification Essential details include the vehicle's make, model, year, color, and VIN.
Owner's Information The report requires the owner's name, address, and contact number for follow-up.
Recovery Process Details about the recovery of the vehicle must be documented, including the officer's information.
Distribution of Report The form has two parts: one for the police and one for the individual making the complaint.
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