Details of Individual Completing Renewal

Enter the name, address, and phone number of the individual completing this renewal. If you do not know the exact name or address, enter as much information as you know.


To continue, click the NEXT button.


To go back to the prior page, click the PREVIOUS button.


To save the renewal or exit the page, click the SAVE & EXIT button. This takes you to the SAVE and EXIT screen where you have a choice of saving or continuing to work on the renewal.


To close this window and return to ConneCT, click the CANCEL & EXIT button.