Colorado Dr 2489A – Fill Out and Use This PDF

Records may be provided to a person in interest or a federal, state or local government agency carrying out its official functions, with a signed requestor release and affidavit of intended use. C.R.S 42-1-206, C.R.S. 42-4-1804, C.R.S.

42-6-115, C.R.S. 42-6-118 C.R.S. 24-72-204 (Driver Privacy Protection Act) 18 U.S.C.§ 2721 Prohibition on Release of Personal Information from State Motor Vehicle Records

B. Providing a blanket release for search activities related to the Abandoned Vehicle Process. This release is

required to be submitted annually along with a registration form for all tow or repair facilities and their agents, and law enforcement agencies and their agents who want to search vehicle information as a result of abandoned vehicle tows or vehicles abandoned at repair facilities.

Law Enforcement Officers: Badge # is acceptable in lieu of Driver’s License.

a. Law Enforcement agencies, Tow Carriers and Repair facilities wishing to participate in the abandoned

vehicle process are required to complete sections 1, 2, 3a, 4 and 5

Please contact the Title and Registration Section with any questions at 303-205-5608.

If your application has been rejected and you need to resubmit, return all previously submitted documents along with the additional information required with no additional payment.

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Section 3 (If no box is checked in section 3, applicant must check applicable box in section 3a)

Attached is a written consent of the person whose record is being requested using a Power of Attorney or Letter of Authorization from the vehicle owner of record.

This is my record.

Section 3a - Information may be used only for the following approved, permissible, use: (must check 1 box only)

For use by any government agency, including any court or law enforcement agency, in carrying out it’s functions, or any private person or entity acting on behalf of a Federal, State, or Local Government agency in carrying out its functions;

An agency charged with driver/motor vehicle safety or theft including: motor vehicle product alterations, recalls, advisories, motor vehicle performance monitoring, motor vehicle parts/dealers, motor vehicle market research or surveys, removal of non-owner records from original records of motor vehicle manufacturers

A business that conducts research activities, and for use in producing statistical reports, so long as the personal information is not published, re-disclosed, or used to contact the parties in interest

In connection with a civil, criminal, administrative, or arbitral proceeding in any court or before a self-regulatory body, including process service, investigation, execution of judgment or pursuant to a court order

An insurer or insurance support agency in connection with claims, investigations, anti-fraud activities, rating, or underwriting

To provide notice to owners of towed or impounded vehicles. Copy of tow ticket is required.

Research activity to verify if record is “Junk”, “Salvage”, or “Rebuilt from Salvage”. Copy of ownership document is required.

Bonding for Colorado title or Application for Assigned ID. Copy of a DR 2704 Certified VIN Inspection are required

By a business that will use the information to verify the accuracy of information submitted by individuals for the purpose of preventing fraud,

pursuing legal remedies against, or recovering a debt or security interest.

By an insurer, or a salvage pool that is licensed as a Colorado used motor vehicle dealer, that is subject to an insurance claim or being possessed by a salvage pool.

Section 4 - Additional Information (check if Applicable)

Attorney Bar Number

Section 5

Under Penalty of Perjury, I attest that I shall not obtain, re-sell, transfer, or use the information in any manner prohibited by law. I understand that motor vehicle records that are obtained, resold, or transferred for purposes prohibited by law may subject me to civil penalties under federal and state law.

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Type of Record Data/ Information (Mandatory, unless bonding for title)

Disclose what data/ information is to be included in the record search. Information released will be limited to data/ information that is permitted by Federal and State laws.

I certify, under penalty of perjury in the second degree, that the above facts are true and correct to the best of my knowledge.

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The State may convert your check to a one time electronic banking transaction. Your bank account may be debited as early as the same day received by the State. If converted, your check will not be returned. If your check is rejected due to insufficient or uncollected funds, the Department of Revenue may collect the payment amount directly from your bank account electronically.

No refunds will be granted. Make check or money order payable to: Colorado Department of Revenue

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