"Special Request Form" - Connecticut

Special Request Form is a legal document that was released by the Connecticut Secretary of the State - a government authority operating within Connecticut.

Form Details:

  • Released on September 19, 2018;
  • The latest edition currently provided by the Connecticut Secretary of the State;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Connecticut Secretary of the State.

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Download "Special Request Form" - Connecticut

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FINANCIAL UNIT USE ONLY
Amt. Rec’d:
Office of the Secretary of the State
Trans. ID:
State of Connecticut
Batch Date:
P.O. Box 150470, Hartford, CT 06115-0470
Customer ID: (if any)
Special Request Form
Checks should be made payable to “Secretary of the State”. We no longer accept credit card payments.
Effective Date: September 19, 2018
Date of Request:
Name of Business Requesting
Information (if applicable):
Primary Contact Name:
Address:
City / State / Zip
Phone Number:
Email Address:
Requested Information - $50.00 per request
Ex. Run a search of companies who have John Doe listed as their registered agent
Sample of a search request:
(active and inactive).
Search 1:
Search 2:
Search 3:
Search 4:
Search 5:
FINANCIAL UNIT USE ONLY
Amt. Rec’d:
Office of the Secretary of the State
Trans. ID:
State of Connecticut
Batch Date:
P.O. Box 150470, Hartford, CT 06115-0470
Customer ID: (if any)
Special Request Form
Checks should be made payable to “Secretary of the State”. We no longer accept credit card payments.
Effective Date: September 19, 2018
Date of Request:
Name of Business Requesting
Information (if applicable):
Primary Contact Name:
Address:
City / State / Zip
Phone Number:
Email Address:
Requested Information - $50.00 per request
Ex. Run a search of companies who have John Doe listed as their registered agent
Sample of a search request:
(active and inactive).
Search 1:
Search 2:
Search 3:
Search 4:
Search 5: