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STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH Emergency Vehicle Short-Form Application Pursuant to PA 06-195 Date: 1 Name of Service License/Certificate number 2 Address Town Zip 3 Primary Service

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What is emergency vehicle short-form application?

Emergency vehicle short-form application is a document that is used to request special permits or exemptions for emergency vehicles, allowing them to bypass certain traffic rules and regulations in order to respond to emergency situations more effectively and efficiently.

Who is required to file emergency vehicle short-form application?

Emergency vehicle short-form application must be filed by organizations or agencies responsible for operating emergency vehicles, such as fire departments, police departments, and medical response teams.

How to fill out emergency vehicle short-form application?

To fill out emergency vehicle short-form application, one must provide detailed information about the organization or agency responsible for the emergency vehicle, the specific vehicle details, and the reasons for requesting the special permits or exemptions.

What is the purpose of emergency vehicle short-form application?

The purpose of emergency vehicle short-form application is to streamline the process of granting special permits or exemptions to emergency vehicles, ensuring that they can respond to emergencies quickly and safely without being hindered by traffic rules and regulations.

What information must be reported on emergency vehicle short-form application?

Emergency vehicle short-form application requires information such as the name of the organization or agency operating the emergency vehicle, the vehicle identification number (VIN), license plate number, make and model of the vehicle, and the specific permits or exemptions being requested.

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