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Colorado Non-Use of Vehicle Or Out of State Insurance Affidavit Form

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This form is provided by Colorado Department of Revenue.

Colorado Non-Use of Vehicle Or Out of State Insurance Affidavit Form
Colorado Non-Use of Vehicle Or Out of State Insurance Affidavit Form
non-use of vehicle
or
out of state insurance affidavit
DR 2303 (07/22/10)
colorado department of revenue
DIVISION OF MOTOR VEHICLES
REGISTRATION SECTION
www.colorado.gov/revenue
oWner information
Last Name First Name Middle Initial
Address
City State ZIP
Date of Birth Driver License Number
vehicle information
Make Model Year
Vehicle Identication Number (VIN) Plate Number
period of non-use
Vehicle is not being operated by the owner and the owner shall not
permit any other person to operate the vehicle during the following
time period.
CANNOT EXCEED 12 MONTHS
FROM TO
Month Day Year Month Day Year
You must have insurance coverage on another vehicle that you
own in compliance with §42-3-105(1)(d)(I)
.
Insurance Company Policy Number Effective Date
out of state insurance
I am a resident of Colorado temporarily residing outside
of Colorado and have purchased insurance for the above
vehicle from a company located in the state in which I am
temporarily residing.
Insurance Company State Policy Number Effective Date
Please attach proof of temporary out of state residency (i.e.
Student Identication Card, Utility Bill, etc.)
I certify, under penalty of perjury, that the above statements are true and accurate to the best of my knowledge.
Signature Date
NOTE: This afdavit must be completed annually.
Please return this form to the County Clerk in the county of your permanent residence.
Colorado Non-Use of Vehicle Or Out of State Insurance Affidavit Form