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CISSUSERAUTHORIZATIONREQUEST/AGENCYFORM
55FarmingtonAvenue,Hartford,CT06105
CJISHelpDesk:(860)6222000CJIS.HelpDesk@ct.gov
TYPEofACCESSRequested:NEWMODIFYTERMINATE
IfModifyorTerminate(ProvideCurrentUserID)
Section1CJISUserIdentificationPleaserefertotheCISSUserAuthori
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Please choose a date refers to selecting a specific date for an event or deadline.
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Individuals or entities involved in the event or requirement associated with that specific date are required to file.
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To fill out please choose a date, you typically need to provide relevant information related to the event or requirement along with the chosen date.
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