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Duplicate License Request Form (Bail Bonds Licensee Only)

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Form Instructions

INSTRUCTIONS: CONNECTICUT APPLICATION FOR DUPLICATE/REPLACEMENT SURETY BAIL BOND AGENT LICENSE

Connecticut bail bond agents may apply for a duplicate or replacement copy of their license by filing the application discussed in this article. This document can be obtained from the website of the government of Connecticut.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 1: In the first four blank boxes, enter your Social Security number, license number, date of birth and the name of the applicant.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 2: In the next four blank boxes, enter your street address, city, state and zip code.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 3: If your mailing address is different from your business address, enter its street address, city, state and zip code in the next four blank boxes.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 4: Enter your home phone number and email address in the next two blank boxes.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 5: In the next blank box, enter your business name if you are the owner, partner, or an officer or director. Otherwise, enter your employer's name.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 6: If your business address is different from those listed above, enter the street address, city, state and zip code in the next four blank boxes.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 7: Enter the business phone number, email address and web site address in the next three black boxes.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 8: In the next blank box, provide a detailed explanation for your request for a duplicate or replacement license.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 9: Answer questions 1 through 6 about your background by checking "yes" or "no" as applicable.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 10: Enter your signature on the first blank line at the bottom of the form.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 11: Enter the date on the second blank line.

Connecticut Application For Duplicate/Replacement Surety Bail Bond Agent License Step 12: Print your name on the last blank line.

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