DMV Connecticut 3/10/18, 1(46 AM

Emission Late Fee Payment

Thank you for your payment. Your confirmation number is 2018-41665 . Please keep a copy of this receipt for your
records.

Customer Information:

First Name : MI
Last Name : PHAN
Plate# : AC44995
Mailing Address : 575 PLEASANT ST , SOUTHINGTON, CT, 06489

Billing Information:

First Name : PHU

Last Name : PHAN
Billing Address : 575 PLEASANT ST , SOUTHINGTON, CT, 06489
Card No. : ************0356

Payment Detail:

Vehicle VIN:1FADP3K28EL457275,
Make:Ford, Year:2014, Fee
Date:02/20/2018, Status:Paid

Emissions Late Fee Total: $20.00

about:blank Page 1 of 1