Colorado Non-use of Vehicle Or Out Of State Insurance Affidavit Form

Use this template/form as a Non-use of Vehicle Or Out Of State Insurance Affidavit in the State of Colorado

colorado-non-use-of-vehicle-or-out-of-state-insurance-affidavit-form

Text version of this Form

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DR 2303 (07/22/10)

colorado department of revenue

Division of motoR vehicles

ReGistRAtion section

www.colorado.gov/revenue

non-use of vehicle

or

out of state insurance affidavit

oWner information

last name first name middle initial

Address

city state ZiP

Date of Birth Driver license number

vehicle information

make model Year

Vehicle Identification Number (VIN) Plate number

period of non-use

cAnnot eXceeD 12 months

vehicle is not being operated by the owner and the owner shall not fRom to

month Day Year month Day Year

permit any other person to operate the vehicle during the following

time period.

insurance company Policy number effective Date

You must have insurance coverage on another vehicle that you

own in compliance with ยง42-3-105(1)(d)(i).

out of state insurance

insurance company state Policy number effective Date

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 Please attach proof of temporary out of state residency (i.e.

temporarily residing. Student Identification 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 affidavit must be completed annually.

Please return this form to the county clerk in the county of your permanent residence.