STATE OF CONNECTICUT
DEPARTMENT OF MOTOR VEHICLES
[Link]/dmv We'd like to hear from you!
Date: 3/25/2026 CONGRATULATIONS
OENDY YOCASTA BAEZ LOPEZ
DRIVE-ONLY
YOU HAVE SUCCESSFULLY SCHEDULED YOUR LEARNER PERMIT VISION AND KNOWLEDGE TEST APPOINTMENT
ALL DOCUMENTS PRESENTED TO THE DMV MUST BE ORIGINAL OR CERTIFIED COPIES.
PHOTOCOPIES WILL NOT BE ACCEPTED.
BE PREPARED. Bring the following REQUIRED documents with you!
Please refer to the DRIVE ONLY document checklist on page 3 or at [Link]/dmv/driveonly for a complete list of acceptable
documents to answer 1-3 below.
1. IDENTITY: You must present two forms of identification. At least one of the documents must be from the primary document list.
My primary document I will present is: , my 2nd is
2. CONNECTICUT RESIDENCY: You must present two different pieces of mail or electronic mail from two different sources. Mail
must show your name and Connecticut residence address, be dated 90 days or older, but not more than two years old; unless stated
otherwise on document checklist.
My 1st proof of residency I will present is: , my 2nd is
3. NAME CHANGE DOCUMENTS, if applicable: If there have been multiple name changes, you must provide documentation to
prove the continuity of the names.
My name change document(s) I will present is (are):
4. A printout of this appointment confirmation page.
5. The completed R229 application, page 2.
Bring your glasses or contact lenses, if needed, for testing. If you fail the vision test you will not be able to proceed to
the knowledge test and will be required to reschedule.
If under 18, parent or legal guardian must accompany you with their identification to sign the parental consent
(Legal guardian must present certificate of legal guardianship from the court).
If parent or legal guardian is unable to come with you, you must present a notarized certificate of parental consent form (Form
2-D).This form can be found on our website [Link]
Study the Connecticut Driver's Manual You will be required to reschedule, wait seven days and repay the test fee if you fail the
test.
Effective January 1, 2026, a new CT Law requiring new drivers to complete an online “Connecticut Work Zone Safety Course”.
If you fail to comply with the above requirements you will not be allowed to test and must reschedule your appointment.
If you fail to appear at your scheduled time you will be required to reschedule and repay the test fee.
If you are unable to keep this appointment and are rescheduling within two days of your appointment date you will be required to
repay the test fee. If you are canceling within two days of your appointment date you will not be eligible for a refund of the test fee.
APPOINTMENT DETAILS
PIN CODE: 688KKG84 Fee: Learner Permit: $19.00
Date/Day/Time: 4/25/2026 Saturday 8:00 AM Test Fee: $40.00
Testing Location: 1985 State Street, Hamden, CT, 06517 Total:
$59.00
Authorization Code: 110035 Payment Date: 3/25/2026
PIN: 688KKG84 4/25/2026 Saturday 8:00 AM 1985 State Street, Hamden, CT, 06517 $59.00
DMV USE OUT OF STATE DRIVE ADD/REMOVE
NEW TRANSFER ONLY ENDORSEMENT/RESTRICTION EXCHANGE RETEST
ONLY
APPLICATION FOR A NON-COMMERCIAL
LEARNER PERMIT AND/OR DRIVER LICENSE STATE OF CONNECTICUT
R-229 REV. 7-2023 DEPARTMENT OF MOTOR VEHICLES
On The Web At [Link]/dmv
INSTRUCTIONS: Complete 1-18, then present
1. Required Identification Documents & Proof of Connecticut
Residency: see "Acceptable Forms of ID" at [Link]/dmv
DRIVE-ONLY
2. 16 and 17 year olds: Certificate of Parental Consent Form 2D
NO FEE LEARNER PERMIT NUMBER DATE OF ISSUE
(if not accompanied by authorized individual)
3. Applicable Fees US MILITARY
1. APPLICANT'S NAME (Last, First, Middle, Suffix) 2. GENDER 3. DATE OF BIRTH 4. HEIGHT 5. COLOR OF EYES
BAEZ LOPEZ, OENDY, YOCASTA M F X 7/6/1979 ft. in.
6. MAILING ADDRESS (No., Street, City or Town, State, Zip Code) 7. RESIDENCE ADDRESS (If different from mailing address)
54 BALDWIN ST, BRIDGEPORT, CT, 06607
8. US CITIZEN? If "NO", list ALIEN REGISTRATION NO. 9. CONNECTICUT 10. DO YOU WANT TO BE IN THE ORGAN/TISSUE DONOR 11. DAYTIME PHONE NO.
RESIDENT? REGISTRY? If yes, you are agreeing to be a donor
Yes No DRIVE ONLY Yes No Yes No
and the designation will be on your
license. ( ) 475 393-4692
12. SOCIAL SECURITY NUMBER 13. LIST ANY OTHER NAMES EVER USED (Alias, Maiden, etc) 14. E-MAIL ADDRESS
ELPASIFICO1828@[Link]
QUESTIONS YES ( ) NO ( )
15. Have you previously failed a driver's license FAILED LOCATION DATE
examination in Connecticut? VISION KNOWLEDGE ROAD
16. Do you now, or have you ever held a Connecticut Learner Permit, PERMIT, LICENSE OR ID NO. (9 digits) EXPIRATION DATE NO. OF YEARS
License or Non-Driver Identification Card?
17. Do you now, or have you ever held an Operator's License or STATE DRIVER LICENSE OR ID. NO. EXPIRATION DATE NO. OF YEARS
Identification Card from another state?
IN WHAT STATE(S)?
18. Is your privilege to operate a motor vehicle suspended or subject to
suspension in Connecticut or in any other state?
Section 14-36l of the Connecticut General Statutes requires the Commissioner to transmit my
SELECTIVE information to the Selective Service System. By signing and submitting this application, I consent I hereby certify that I do not
to be registered with the Selective Service System, provided I am at least age 16 but under age MEDICAL have any health or vision
SERVICE 26 and meet the criteria for registration in accordance with the Military Selective Service Act. If I problems or conditions that
CERTIFICATION
CONSENT am under age 18, I understand that my information will be transmitted to Selective Service but I prevent me from driving safely.
will not be registered until I reach age 18.
The information provided to the Commissioner of Motor Vehicles herein is SIGNATURE OF APPLICANT DATE SIGNED
subscribed by me, under penalty of false statement, in accordance with
CERTIFICATION the provisions of Section 14-110 and 53a-157b of the Connecticut General
BY APPLICANT Statutes. I understand that if I make a statement which I do not believe to
be true, with the intent to mislead the Commissioner, I will be subject to
prosecution under the above-cited laws. X
DO NOT WRITE BELOW THIS LINE - OFFICE USE ONLY
PROOF OF TYPE OF IDENTIFICATION SHOWN EXAMINERS INITIALS STAMP NO.
I.D. SCANNED FIRST VISIT
IDENTIFICATION
FULL LEGAL If different than entered in name section above (# 1)
NAME
PARENTAL I hereby request that a learner's permit RELATIONSHIP TO MINOR SIGNED (Authorized Consenter) CONSENTER'S LIC. NO. OR OTHER I.D.
CONSENT and/or license be issued to the minor
AGE 16 OR 17 ONLY filing this application. X
VISION VISUAL AID USED RESULTS AGENTS INITIALS PUNCH NO. AND PUNCH
SCREENING NONE GLASSES/CONTACTS PASSED FAILED
RESULTS
KNOWLEDGE TEST RESULTS APPLICANTS INITIALS CONFIRMING IDENTIFICATION
DOCUMENTS RETURNED
TEST COMPUTER/AUDIO WRITTEN WAIVED PASSED FAILED
ISSUE PERMIT WITH CORRECTIVE ISSUE DRIVE ONLY
PERMIT ISSUE LEARNER PERMIT ISSUE MOTORCYCLE PERMIT LENSES (B-RESTRICTION) (Y-RESTRICTION)
AGENT I hereby certify that I have examined the applicant's identity SIGNED (Agent) PUNCH NO. AND PUNCH DATE SIGNED
documents and the test results stated herein are true and
CERTIFICATION correct. X
CLASSROOM SCHOOL NAME COMMERCIAL SCHOOL LICENSE NO. DRIVER EDUCATION CERTIFICATE NO.
DRIVER INSTRUCTION
TRAINING PRACTICE SCHOOL NAME (If same as above print "same") COMMERCIAL SCHOOL LICENSE NO. DRIVER EDUCATION CERTIFICATE NO.
DRIVING
I hereby subscribe and certify under penalty of false statement, in accordance with the provisions of Section 14-110 and 53a-157b of the Connecticut General Statutes that I
understand that if I make a statement, which I do not believe to be true, with the intent to mislead the Commissioner I will be subject to prosecution under the above-cited laws, that,
HOME I am qualified under Section 14-36, of the Connecticut General Statutes, over 20 years of age, have no suspensions within the previous 4 years and the Applicant has received the
required training, including the equivalent of 22 hours classroom training; 40 hours on-the-road instruction; the 8 hours Safe Driver course, including a 2 hour Parent Training, as
TRAINING/ supported by a parent log and/or driving school certificate.
COMMERCIAL 1 2 3 SIGNATURE OF INSTRUCTOR (Home Training/Commercial) OPERATOR LICENSE NUMBER OR
SCHOOL LICENSE NUMBER
TRAINING Home Training Comm/Sec and Home Comm/Sec Only
22 hr class equiv 30 hrs class/minimum 30 hrs class
CERTIFICATION 40 hr on-the-road 8 hr safe driving plus home 40 hrs on-the-road
8 hr safe driving training 40 hrs on-the-road X
SPECIAL EQUIPMENT
ROAD TEST WAIVED PASSED FAILED
AND LICENSE NON-COMMERCIAL CLASS ENDORSEMENT RESTRICTIONS (Circle All Applicable)
INFORMATION
D M Q 3 B C D E F G R U Y
AGENT I hereby certify that I have verified the applicant's SIGNED (Agent) PUNCH NO. AND PUNCH DATE SIGNED
identity and the test results stated herein are true
CERTIFICATION and correct. X
DRIVE ONLY DOCUMENT CHECKLIST Connecticut DMV
To obtain a new learner permit or renew your Drive Only license you must provide original or certified documents.
Out of state learner permits are not transferable.
Photocopies, notarized photocopies, non-certified copies, and damaged or mutilated documents are not
acceptable. DMV will scan and store images of all documents.
If any document is in a language other than English, it must be translated by a DMV approved translator. See list
of DMV approved translators here.
US Citizens and documented immigrants and non-immigrants (including B1 and B2 visitors) are NOT eligible for a
Drive Only credential. [Link]/dmv/driveonly
You must schedule an appointment online.
IDENTITY:
You must present two forms of identification; at least one document must be from the Primary document list.
PRIMARY document list
Foreign Passport (not expired for more than 3 years)
Valid, unexpired consular identification document issued by your country of citizenship
* If you have an expired B-1/B-2 status, you can obtain a Drive Only license if you can provide the expired I-94 or
the B-1/B-2 admission stamp in your foreign passport is older than 1 year.
SECONDARY document list
Valid foreign national identification card (current or expired)
Valid, unexpired motor vehicle operator's license, with security features, issued by another state or country
Original birth certificate with a raised seal issued by a foreign country
Marriage certificate issued by any state or territory of the United States
AND
CONNECTICUT RESIDENCY:
The Drive Only law requires you to be a resident of Connecticut for at least 90 days. To prove this:
• You must bring two pieces of mail or electronic mail from two different sources that show you receive mail at your home in Connecticut.
• If you moved within the past 90 days, you must bring four pieces of mail; two pieces of mail addressed to you at your new address and two pieces of mail
addressed to you at your old Connecticut address that are older than 90 days from List A or older than 12 months from List B as of the date you come to DMV.
As of the date you come to DMV, all mail:
• Must include your name and Connecticut residence address
• Must be dated older than 90 days from List A
• Must be dated older than 12 months from List B
• Cannot be dated older than two years
The two proofs of residency can be from either List A or List B.
List A (Older than 90 Days) List B (Older than 12 Months)
Bill from a bank or mortgage company, utility company, credit card Property or excise tax bill
company, doctor or hospital Annual benefits summary statement from the Social Security
Bank statement or bank transaction receipt showing the bank's name Administration or other pension or retirement plan
and mailing address Homeowner's insurance or renter's insurance policy or motor vehicle
Preprinted pay stub insurance card or policy
Medicaid or Medicare benefit statement Residential mortgage or similar loan contract, lease or rental contract
Postmarked mail showing signatures from all parties needed to execute the agreement
Change of address confirmation from the United States Postal Service
indicating an applicant's current and prior address
Survey of an applicant's real property issued by a licensed surveyor
Official school records showing enrollment
Parents or legal guardian of minor may provide any two pieces of mail addressed to the parent residing at same address to prove minor residency, or use their
own CT driver license or ID which shows the same address as one of the two required proofs of residency.
AND
NAME CHANGE DOCUMENTS (if applicable):
Marriage or civil union certificate (certified copy issued by town/city)
Marriage or civil union dissolution
Probate court name change document
If there have been multiple name changes, you must provide documentation to prove the continuity of the names.
When you schedule an appointment online, you will sign an affidavit that you will file an application to legalize your immigration status when you are eligible.
The Connecticut DMV will check your criminal history. If you have a Connecticut felony, you will not be eligible for a Drive Only credential or a refund of any fees
collected.
If you have a question regarding acceptable documents, please phone the DMV Contact Center 860-263-5700.
DI-4 Rev. 9-2018