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How to fill out Connecticut SR-101

The form for the letter that arrives after a sale you thought was finished. Connecticut's insurers report cancellations to the DMV, and a policy cancelled before the registration was terminated reads as a lapse on a live registration. The SR-101 is how a seller answers that: it tells the Insurance Compliance Unit what actually happened to the car, on what date, and to whom - and it names, in its own instructions, the documents that prove it.

Written against SR-101 (New 8-2008), issued under Conn. Gen. Stat. s. 14-12b and s. 14-12g, mandatory security and the suspension of a registration for a lapse. This form is dated 2008 and prints an old web address, http://dmvct.org, at the head. It is still the current form for the purpose - the department links it from its compliance pages - but check the Insurance Compliance Unit address on your own notice before posting, because the notice carries the current one.

Two documents, and they are not the same thing. Take the blank SR-101 from the portal.ct.gov copy so you get the revision that is current today.

Filled in

What a completed one looks like

This is the actual SR-101, rendered from the PDF the Connecticut Department of Motor Vehicles publishes and completed end to end: letterhead, every field, and the blocks at the foot.

A completed Connecticut Disposition of Vehicle form, SR-101. The applicant is Theodore N. Bascomb of 31 Coe Avenue, Meriden, CT 06450. The vehicle is a 2011 Hyundai Sonata with identification number 5NPEB4AC7BH255170 and plate number AK52901. Plates canceled is answered YES with a date of 12 August 2026. The SOLD box is ticked with a date of 10 August 2026 and the name of buyer Desmond K. Ferraiolo. The insurance cancellation date is 14 August 2026 with the policy number filled in. The JUNKED, REPOSSESSED and DONATED lines are shaded.
Filled in the way a seller wants it to read: the plates cancelled two days after the sale, the insurance cancelled two days after that, and the sequence in the right order. Every name, date and number here is invented for the sample.
Field by field

Every line, in the order you meet it

  1. 1
    You fill this in

    Name and Address of Applicant

    Yours, as they appear on the notice. The case number goes in the box at the top of the sheet, copied from that notice.

    Watch out: Use the version of your name on the notice even if it is out of date, and mention the correction separately. Matching the file is what gets it read.

  2. 2
    You fill this in

    Vehicle Information: make, model, year, VIN

    Four boxes identifying the car the case is about.

    Watch out: The VIN is the item the department reconciles against the insurer's report. A plate number alone is not enough where plates have moved between vehicles.

  3. 3
    You fill this in

    Plate Number on Vehicle

    The registration the lapse was reported against.

    Watch out: If the plate has already been cancelled, this is the number printed on your plate disposition receipt - which is also the document instruction one tells you to attach.

  4. 4
    You fill this in

    Plates Canceled? and the date

    YES or NO with a date, and the plate receipt attached.

    Watch out: This is the answer that decides the case. A YES with a date earlier than the insurance cancellation is the whole defence in two boxes.

  5. 5
    You fill this in

    SOLD, with the date and the buyer's name

    One of four dispositions. Tick it, date it and name the person who took the car.

    Watch out: The date has to match the assignment on the title you are attaching. Two different sale dates on two documents is worse than one late one.

  6. 6
    You fill this in

    Date Insurance Canceled, insurer and policy number

    The other end of the timeline, in the department's own three boxes. The certification and signature close the sheet below them.

    Watch out: Fill this in honestly even where it is unhelpful - the department already has the date from the insurer. And attach before you sign: a signed form posted without the plate receipt and the title copy is a case that closes against you for lack of evidence.

At a glance

What goes where

On the formWhat to put in it
Case NumberPrinted on the notice you received. It is what ties this sheet to the file already open on you.
Name of Applicant, and Address of ApplicantYours, matching the file the Insurance Compliance Unit already has open.
Vehicle Information: Make, Model, Year, Vehicle Identification NumberFour boxes identifying the car the case is about.
Plate Number on VehicleThe registration the lapse was reported against.
Plates Canceled? YES or NO, and If Yes, Date CanceledThe single most important answer on the sheet, and a date to go with it.
I ceased to operate the vehicle on the road and removed the registration plates from this vehicle. The vehicle has been:The declaration, followed by four alternatives.
SOLD (Indicate date), Name of BuyerThe seller's line: a date and a name.
JUNKED (Indicate date), Name of JunkyardFor a car handed to a recycler.
REPOSSESSED (Indicate date), Name of LenderFor a vehicle taken back by a lienholder.
DONATED VEHICLE TO CHARITY (Indicate date), Name of CharityFor a donation, which the department treats as its own category.
Date Insurance Canceled on this Vehicle, Name of Insurance Company, Policy NumberThe other half of the timeline. The department reads this date against the sale date and the cancellation date.
Certification Statement, Signature of Applicant, Date SignedSubscribed under penalty of false statement in accordance with Section 14-110 and 53a-157b.

What gets this one rejected

Rules that decide whether it is accepted

Every line here was read off SR-101 (New 8-2008) itself — the PDF is here — and off the Connecticut Department of Motor Vehicles pages. This is plain-language help with a form, not legal advice, and where our wording and the agency's differ, theirs governs.

Back to all Connecticut seller paperwork, or what selling a car in Connecticut involves.

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