Dr 2680 Form Colorado – Fill Out and Use This PDF

In order for the Department to accept the form, all 3 sections must be completed in full.

Under Please Print Full Name, print your name to attest to the following facts concerning your State of residency.

On 1., enter the Date (MM/DD/YY) when you became a resident of the State of the State you enter.

Enter your Current Address, City, State, ZIP Code and Date of Birth (MM/DD/YY).

In 2, enter the Date (MM/DD/YY) when you applied for a driver's license or ID in the State you entered in 1.

Sign under Signature of Driver (affidavit) and enter the Date (MM/DD/YY): you swear and attest that the aforementioned statements are true and correct, under the penalties of perjury. If you return to the State of Colorado prior to the expiration date of the SR22 requirement period, you will be required to provide an SR22 for the balance of the period of requirement.

The notary completes "Subscribed and affirmed, or sworn to before me in the" County of and State of, and "this day of , 20".

The notary enters the Notary Seal, the Notary Signature and the Commission Expiration Date.

A driver's licensing official in the state of residence completes the Driver's Licensing Official section.

The section states that the named person has either obtained/applied or attempted to apply for a driver's license in this state; if cleared by the State of Colorado, the driver is eligible for driving privileges in this state.

The official enters the Licensing Official's Name, Title, State, Date (MM/DD/YY), Mailing Address, City, State, ZIP Code and Phone Number, and signs under Licensing Official's Signature.