Form H-123 Self-service Storage Facility Filing of Business Information - Connecticut

Form H-123 or the "Self-service Storage Facility Filing Of Business Information" is a form issued by the Connecticut Department of Motor Vehicles.

The form was last revised in March 1, 2018 and is available for digital filing. Download an up-to-date Form H-123 in PDF-format down below or look it up on the Connecticut Department of Motor Vehicles Forms website.

ADVERTISEMENT
STATE OF CONNECTICUT
SELF-SERVICE STORAGE FACILITY
DEPARTMENT OF MOTOR VEHICLES
FILING OF BUSINESS INFORMATION
60 STATE STREET, WETHERSFIELD, CT 06161
H-123 Rev. 3-2018
DEALERS AND REPAIRERS SECTION
On The Web at ct.gov/dmv
INSTRUCTIONS
1.
Self-Service Storage Facilities must submit a one time filing of business information with the DMV.
2.
Complete all sections.
3.
Attach sample rental agreement and mail original form to the address above.
4.
Upon receipt, DMV will notify you of approval or denial via regular mail or email.
NAME OF BUSINESS
NAME(S) OF PERSON(S) AUTHORIZED TO SIGN ON BEHALF OF BUSINESS
ADDRESS OF BUSINESS (No. and Street)
(City or Town)
(State)
(Zip Code)
MAILING ADDRESS OF BUSINESS (IF DIFFERENT FROM ABOVE)
BUSINESS
INFORMATION
EMAIL ADDRESS
BUSINESS TELEPHONE NUMBER
SALES AND USE TAX PERMIT NUMBER
CHECK HERE
TO INDICATE YOU HAVE ATTACHED A SAMPLE RENTAL AGREEMENT
ANY CHANGES IN THE INFORMATION REQUIRED BY THIS FORM SHALL BE MADE IN WRITING AND SUBMITTED TO THE
DEPARTMENT OF MOTOR VEHICLES WITHIN TEN DAYS.
The information provided to the Commissioner of Motor Vehicles herein is subscribed by me, under penalty of false statement, in
accordance with the provisions of Sections 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
CERTIFICATION
above-cited laws.
AUTHORIZED SIGNATURE OF BUSINESS OWNER/PRINCIPAL
DATE SIGNED
X
STATE OF CONNECTICUT
SELF-SERVICE STORAGE FACILITY
DEPARTMENT OF MOTOR VEHICLES
FILING OF BUSINESS INFORMATION
60 STATE STREET, WETHERSFIELD, CT 06161
H-123 Rev. 3-2018
DEALERS AND REPAIRERS SECTION
On The Web at ct.gov/dmv
INSTRUCTIONS
1.
Self-Service Storage Facilities must submit a one time filing of business information with the DMV.
2.
Complete all sections.
3.
Attach sample rental agreement and mail original form to the address above.
4.
Upon receipt, DMV will notify you of approval or denial via regular mail or email.
NAME OF BUSINESS
NAME(S) OF PERSON(S) AUTHORIZED TO SIGN ON BEHALF OF BUSINESS
ADDRESS OF BUSINESS (No. and Street)
(City or Town)
(State)
(Zip Code)
MAILING ADDRESS OF BUSINESS (IF DIFFERENT FROM ABOVE)
BUSINESS
INFORMATION
EMAIL ADDRESS
BUSINESS TELEPHONE NUMBER
SALES AND USE TAX PERMIT NUMBER
CHECK HERE
TO INDICATE YOU HAVE ATTACHED A SAMPLE RENTAL AGREEMENT
ANY CHANGES IN THE INFORMATION REQUIRED BY THIS FORM SHALL BE MADE IN WRITING AND SUBMITTED TO THE
DEPARTMENT OF MOTOR VEHICLES WITHIN TEN DAYS.
The information provided to the Commissioner of Motor Vehicles herein is subscribed by me, under penalty of false statement, in
accordance with the provisions of Sections 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
CERTIFICATION
above-cited laws.
AUTHORIZED SIGNATURE OF BUSINESS OWNER/PRINCIPAL
DATE SIGNED
X

Download Form H-123 Self-service Storage Facility Filing of Business Information - Connecticut

1448 times
Rate
4.8(4.8 / 5) 101 votes
ADVERTISEMENT