DR 2842 (01/26/11)
COLORADO DEPARTMENT OF REVENUE
DIVISION OF MOTOR VEHICLES
TITLE AND REGISTRATION SECTIONS
www.colorado.gov/revenue
SUPPLEMENTAL SECURE AND VERIFIABLE IDENTIFICATION
INFORMATION AND ATTESTATION CLAUSE
ANY ALTERATION OR ERASURE VOIDS THIS DOCUMENT
This form may be used as an attachment to existing forms inventory which does not contain the secure and veriiable identiication information or attestment. Please attach this completed form to the document(s) being presented for Title and/or Registration.
SECURE AND VERIFIABLE IDENTIFICATION OF
Name as it Appears on Identiication
Agency (If Applicable)
Identiication Information (for acceptable forms of ID please see form DR 2841)
Colorado DL |
Colorado ID |
Other _________________________________________ |
This section to be used with DR 2219 Persons with Disabilities Parking Privileges Application. Identiication shown above belongs to:
Individual (Placard holder) |
Guardian |
Parent |
Business |
* Afidavit of one in the same is required if the name on ID differs in any way from name on title assignment.
*
________________________________________________________________________________________
and _____________________________________________________________________________________
I, certify under penalty of perjury in the second degree, that the above statements are true and accurate to the best of my knowledge.
Signature
The undersigned witness afirms that the identiication described above was presented to me.
Witness Printed Name
DR 2841 (01/26/11)
COLORADO DEPARTMENT OF REVENUE
DIVISION OF MOTOR VEHICLES
TITLE AND REGISTRATION SECTIONS
www.colorado.gov/revenue
Secure and Veriiable ID
Secure and Veriiable ID is required to obtain:
•New Titles
•Duplicate Titles (vehicles purchased on or after 07/01/2006)
•New Registrations
•New Temporary Registration Permits
•New Placards
The following types of identiication are Secure and Veriiable:
•Any Colorado Driver License, Colorado Driver Permit or Colorado Identiication Card, current or expired one year or less. (Valid temporary paper license with in- valid Colorado Driver’s License, Colorado Driver’s Permit, or Colorado Identiication Card, expired one year or less is acceptable.)
•Out-of-state issued photo driver’s license or photo identiication card, photo driver’s permit current or expired one year or less.
•U.S. Passport current or expired less than 10 years.
•Valid foreign passport with I-94 or valid processed for I551 stamps. Valid I-94 is- sued by Canadian government with L1 or R1 status and a valid Canadian drivers license or valid Canadian identiication card.
•Valid I551 Resident Alien/Permanent Resident card. No border crosser or USA B1/ B2 Visa/BCC cards.
•Valid I688 Temporary Resident, I688B, and I766 Employment Authorization Card with intact photo.
•Valid US Military ID (active duty, dependent, retired, reserve and National Guard).
•Tribal Identiication Card with intact photo. (U.S. or Canadian)
•Certiicate of Naturalization with intact photo.
•Certiicate of (US) Citizenship with intact photo.
If you have questions about Secure and Veriiable Identiication, please contact the Title and Registration Sections at 303-205-5608.