INSTRUCTIONS: CONNECTICUT APPLICATION FOR DRIVING SCHOOL LICENSE (Form R-04)

To apply for or renew a license to maintain a Connecticut driving school, a form R-04 should be used. This document can be obtained from the website of the state of Connecticut.

Connecticut Application For Driving School License R-04 Step 1: Indicate with a check mark whether you are filing an original application, a renewal application, or a branch office application.

Connecticut Application For Driving School License R-04 Step 2: In the first three blank boxes, enter the name of the school, its telephone number and its tax identification number.

Connecticut Application For Driving School License R-04 Step 3: In the next two blank boxes, enter the school address and the name and office of branch offices or classrooms.

Connecticut Application For Driving School License R-04 Step 4: In the next two blank boxes, enter the names and addresses of driving school owners. Three pairs of blank boxes are provided for this purpose.

Connecticut Application For Driving School License R-04 Step 5: In the next two blank boxes, write whether a certificate of financial responsibility is on file with the Connecticut Department of Motor Vehicles and the name of your insurance company.

Connecticut Application For Driving School License R-04 Step 6: Enter the policy number for each accident, the amount of insurance for bodily injury per person and per accident, and the amount of insurance for property damage per accident.

Connecticut Application For Driving School License R-04 Step 7: In the table provided at the bottom of the first page, document automobiles to which insurance is applicable which will be used by the school. Enter the year of each automobile in the first column, the make in the second column, the body type in the third column, the identification number in the fourth column, and the registration plate number in the fifth column.

Connecticut Application For Driving School License R-04 Step 8: The table provided at the top of the second page concerns the driving instructors that will be used. Enter their name in the first column, their address in the second column, and their instructor license number in the third column.

Connecticut Application For Driving School License R-04 Step 9: List the fees charged for all services, then print and sign your name and enter the date at the bottom of the form where indicated.