Form A-89 "Transcript Request" - Connecticut

What Is Form A-89?

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 fillable version of Form A-89 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 A-89 "Transcript Request" - Connecticut

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TRANSCRIPT REQUEST
A-89 New 7-2018
STATE OF CONNECTICUT
DEPARTMENT OF MOTOR VEHICLES
ADMINISTRATIVE PER SE UNIT
DMV.AdminPerse@ct.gov
60 STATE STREET, WETHERSFIELD, CT 06161
Telephone: (860) 263-5204
On The Web at ct.gov/dmv
A transcript request from a DMV hearing must be made on this form. Completed transcripts will not be
released without full payment. Checks should be made payable to "DMV" and mailed to 60 State St.,
Room 170, Wethersfield, CT 06161. Use a separate form for each transcript requested.
CASE NAME
DMV CASE NUMBER
TODAY'S DATE
DATE OF HEARING
NAME OF REQUESTER
ADDRESS OF REQUESTER
JURIS NUMBER (If applicable)
PHONE NUMBER
E-MAIL ADDRESS
I understand that the minimum charge for a transcript is $20.00, payment of which is due upon submitting
this request. If the cost of the transcript exceeds $20.00, the remaining amount becomes due when the
transcript has been produced.
The $20.00 minimum payment will be deducted from the total amount
owed. By signing below, I agree that once the transcript has been produced, I am responsible for
payment in the amount of $3.50 per page or $5.00 per page. If the length of the transcript dictates (or if
the transcript is needed expeditiously), we may send the transcript request to an outside vendor. The
outside vendor charges $5.00 per page and any outside vendor will bill you directly.
SIGNATURE OF REQUESTING PARTY
X
DMV USE ONLY
$20.00 MINIMUM FEE RECEIVED BY (Signature)
HEARING REPORTER NAME
TRANSCRIPT COMPLETION DATE
TOTAL NUMBER OF PAGES
AMOUNT OWED AT $3.50 PER PAGE
($20.00)
TOTAL DUE:
FINAL PAYMENT RECEIVED BY: (Signature)
TRANSCRIPT REQUEST
A-89 New 7-2018
STATE OF CONNECTICUT
DEPARTMENT OF MOTOR VEHICLES
ADMINISTRATIVE PER SE UNIT
DMV.AdminPerse@ct.gov
60 STATE STREET, WETHERSFIELD, CT 06161
Telephone: (860) 263-5204
On The Web at ct.gov/dmv
A transcript request from a DMV hearing must be made on this form. Completed transcripts will not be
released without full payment. Checks should be made payable to "DMV" and mailed to 60 State St.,
Room 170, Wethersfield, CT 06161. Use a separate form for each transcript requested.
CASE NAME
DMV CASE NUMBER
TODAY'S DATE
DATE OF HEARING
NAME OF REQUESTER
ADDRESS OF REQUESTER
JURIS NUMBER (If applicable)
PHONE NUMBER
E-MAIL ADDRESS
I understand that the minimum charge for a transcript is $20.00, payment of which is due upon submitting
this request. If the cost of the transcript exceeds $20.00, the remaining amount becomes due when the
transcript has been produced.
The $20.00 minimum payment will be deducted from the total amount
owed. By signing below, I agree that once the transcript has been produced, I am responsible for
payment in the amount of $3.50 per page or $5.00 per page. If the length of the transcript dictates (or if
the transcript is needed expeditiously), we may send the transcript request to an outside vendor. The
outside vendor charges $5.00 per page and any outside vendor will bill you directly.
SIGNATURE OF REQUESTING PARTY
X
DMV USE ONLY
$20.00 MINIMUM FEE RECEIVED BY (Signature)
HEARING REPORTER NAME
TRANSCRIPT COMPLETION DATE
TOTAL NUMBER OF PAGES
AMOUNT OWED AT $3.50 PER PAGE
($20.00)
TOTAL DUE:
FINAL PAYMENT RECEIVED BY: (Signature)