STATE OF CONNECTICUT

DEPARTMENT OF MOTOR VEHICLES

60 State Street, Wethersfield, CT 06161
http://ct.gov/dmv

Date: 9/28/2024 CONGRATULATIONS

WENDY ASPRILLA URRUTIA

YOU HAVE SUCCESSFULLY SCHEDULED YOUR ROAD TEST APPOINTMENT.

This letter confirms the location, date and time of your road test appointment.
• Please arrived at the testing location 15 minutes prior to your test time, on the scheduled date accompanied by a
licensed driver.
• If you are unable to keep this appointment, you must reschedule or cancel prior to 10/2/2024
to avoid repaying the $40 test fee.
• If you fail to appear at your scheduled time you will be required to reschedule and repay the $40 test fee.
BE PREPARED!!
On the date of your road test, you must bring the following:
1. A PRINTED AND COMPLETED R229 APPLICATION, Page 2.
2. YOUR LEARNER’S PERMIT: If you have lost your learner’s permit, you must bring one form of acceptable ID to apply for a
duplicate, and the associated fee payment. (Visit ct.gov/dmv for a list of acceptable ID and fee information.)
3. A PROPERLY REGISTERED AND INSURED VEHICLE: (DMV does not furnish the vehicle.)
An unlicensed driver cannot test in a rented vehicle.
• The vehicle used for the road test must be mechanically safe and pass a pre-trip inspection.
• Common reasons for a failed inspection include, but are not limited to:
Non-compliant Aftermarket Window Tint, Unsafe tires, Defective Windshield, Defective Brake Lights
(including the 3rd brake light, if equipped), Defective Signal Lights, Defective Seat Belts and any other
defective equipment.
4. CURRENT REGISTRATION CERTIFICATE (paper) and current CONNECTICUT INSURANCE CARD (paper, PDF or on App - NO PHOTO's):
• If using an out of state registered vehicle, you must bring the Declaration page of the insurance policy meeting CT
minimum insurance requirements of 25/50/25.
5. ELECTRONIC DRIVER EDUCATION CERTIFICATE: A copy of the e-DEC showing confirmation of the 8 hour Safe Driving Course (or
original CS-1 certificate if applicable).
6. LICENSE FEE: (Visit ct.gov/dmv for fee information.)
7. UNDER 18 APPLICANTS: Your qualified home trainer must appear with their drivers license at the time of your road test to sign
the attesting statement that all statutory driver education/practice driving requirements have been fulfilled.

If you fail to comply with the above requirements you will be required to reschedule your appointment.

Appointment Details

PIN: DRJWAAXL Fee Paid:

Date/Day/Time: 10/4/2024 Friday 10:45 AM Test Fee Prepaid

Testing Location: 1985 State Street, Hamden, CT, 06517 Total

Authorization Code: Payment Date: 9/16/2024

You will be notified by email in the event your road test appointment is cancelled due to office closure/inclement weather.
In these instances, please follow the instructions included in the email you receive in order to reschedule without incurring
additional fees.
PIN: DRJWAAXL 10/4/2024 Friday 10:45 AM 1985 State Street, Hamden, CT, 06517 $0.00
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 ct.gov/dmv
INSTRUCTIONS: Complete 1-18, then present
1. Required Identification Documents & Proof of Connecticut
Residency: see "Acceptable Forms of ID" at ct.gov/dmv
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 119947181
1. APPLICANT'S NAME (Last, First, Middle, Suffix) 2. GENDER 3. DATE OF BIRTH 4. HEIGHT 5. COLOR OF EYES
ASPRILLA URRUTIA, WENDY M F X 11/2/1997 ft. in.
6. MAILING ADDRESS (No., Street, City or Town, State, Zip Code) 7. RESIDENCE ADDRESS (If different from mailing address)
36 BRYANTS BROOK RD, WILTON, CT, 06897
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 Yes No Yes No
and the designation will be on your
license. ( ) 917 975-2081
12. SOCIAL SECURITY NUMBER 13. LIST ANY OTHER NAMES EVER USED (Alias, Maiden, etc) 14. E-MAIL ADDRESS
WENDY.ASPRILLA1997@GMAIL.COM
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