Form B-360 "Request for Administrative Review" - Connecticut

What Is Form B-360?

This is a legal form that was released by the Connecticut Department of Motor Vehicles - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2018;
  • The latest edition provided by the Connecticut Department of Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form B-360 by clicking the link below or browse more documents and templates provided by the Connecticut Department of Motor Vehicles.

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Download Form B-360 "Request for Administrative Review" - Connecticut

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REQUEST FOR ADMINISTRATIVE REVIEW
B-360 Rev. 7-2018
STATE OF CONNECTICUT
DEPARTMENT OF MOTOR VEHICLES
Directions:
1. Submit this sheet with all paperwork either by e-mail, fax, or mail.
2. You will be contacted by DMV as to the results of this review.
Request for Administrative Review
I, the undersigned, request that the Department of Motor Vehicles conduct an administrative review
concerning my recent application for: (Check One).
Motor Vehicle Registration
Operator's License
CDL Operators License
Other
(Please indicate credential applied for)
Name and contact information: (Please print or type)
Full Name:
Address:
Telephone Number: (
Hours of contact:
)
E-Mail Address:
Reason for review:
Justification:
List all documents e-mailed, faxed, or mailed below.
E-mail documents to (DMV.diu@ct.gov), fax documents to 860-263-5581, or mail documents to:
DMV, Attention: Document Integrity Unit, 60 State Street, Wethersfield, CT 06161
X
Signature of applicant:
Date submitted:
IMPORTANT: An administrative review takes approximately 5 calendar days to process.
REQUEST FOR ADMINISTRATIVE REVIEW
B-360 Rev. 7-2018
STATE OF CONNECTICUT
DEPARTMENT OF MOTOR VEHICLES
Directions:
1. Submit this sheet with all paperwork either by e-mail, fax, or mail.
2. You will be contacted by DMV as to the results of this review.
Request for Administrative Review
I, the undersigned, request that the Department of Motor Vehicles conduct an administrative review
concerning my recent application for: (Check One).
Motor Vehicle Registration
Operator's License
CDL Operators License
Other
(Please indicate credential applied for)
Name and contact information: (Please print or type)
Full Name:
Address:
Telephone Number: (
Hours of contact:
)
E-Mail Address:
Reason for review:
Justification:
List all documents e-mailed, faxed, or mailed below.
E-mail documents to (DMV.diu@ct.gov), fax documents to 860-263-5581, or mail documents to:
DMV, Attention: Document Integrity Unit, 60 State Street, Wethersfield, CT 06161
X
Signature of applicant:
Date submitted:
IMPORTANT: An administrative review takes approximately 5 calendar days to process.