Form Dr 7553 PDF Details

Form Dr 7553, which is also known as the "Affidavit of Support" form, is a document that can be used by sponsors to prove their ability to financially support an alien individual who is intending to reside in the United States. The form can be used by both married and unmarried couples, and it must be completed and filed with USCIS prior to the visa interview. In order to complete the form correctly, you will need to provide your personal information, as well as your sponsor's financial information.

QuestionAnswer
Form NameForm Dr 7553
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namescolorado irp form dr 7553, colorado international registration plan application form, dr 7553, colorado apportioned plates

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DR 7553 (04/23/15)

International Registration Plan - Colorado Application

 

Division of Motor Vehicles

 

COLORADO DEPARTMENT OF REVENUE

 

 

Registration Section

If the application is incomplete, it will be returned and not processed.

Schedule A & C

www.colorado.gov/revenue

 

 

I. Schedule A

 

 

Name Of Registrant

Registrant US DOT No.

Account Number

 

License Year

Expiration Month

 

FEIN/SSN

 

 

E-Mail

D/B/A

Original(New)

Renewal

Supplement #

Carrier Type

H – For Hire

 

E – Exempt-Common

 

 

 

 

 

 

 

 

 

MC# ______________

R – Rental Fleet:

 

 

 

 

 

 

(Check Only

Physical Address At Base Location

 

City

 

State

ZIP

P – Private

 

 

SOTpaid at county

 

 

One)

 

 

 

 

New Address

 

 

 

 

 

 

 

 

 

 

M – Household Mover

 

 

 

 

 

 

 

 

 

 

 

Mailing Address (If Different Than Location)

 

City

 

State

ZIP

Ownership Type (Check One)

 

 

 

 

 

New Address

 

 

 

Company

Corporation

Partnership

Sole Owner

 

 

 

 

 

 

Person To Contact Regarding Account

Fax Number

Phone Number

 

 

 

 

Wy Intrastate Authority:

Yes

No

Group Name

Previously Based In Another Jurisdiction?

Yes

No

Vehicle Type:

TT – Truck Tractor

TR – Tractor

TK – Truck (Single)

RT – Road Tractor

ST – Semi-Trailer

FT – Full-Trailer

BS – Bus

If Yes, Jurisdiction:_____________ Expiration Date Of Credentials: ________

If Truck, does it pull a Trailer?

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

II. Please Enter The Weight For Each Jurisdiction. Units Listed On This Page Will Be Authorized To Operate In The Jurisdiction And At The Weights/Axles Listed Below.

AL (Alabama)

AK (Alaska)

AZ (Arizona)

AR (Arkansas)

CA (California)

CO (Colorado)

CT (Connecticut)

DE (Delaware)

DC (Dist. of Col.)

FL (Florida)

GA (Georgia)

ID (Idaho)

IL (Illinois)

IN (Indiana)

IA (Iowa)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

KS (Kansas)

KY (Kentucky)

LA (Louisiana)

ME (Maine)

MD (Maryland)

MA (Mass.)

MI (Michigan)

MN (Minnesota)

MS (Mississippi)

MO (Missouri)

MT (Montana)

NE (Nebraska)

NV (Nevada)

NH (New Hamp.)

NJ (New Jersey)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NM (New Mexico)

NY (New York)

NC (N. Carolina)

ND (N. Dakota)

OH (Ohio)

OK (Oklahoma)

OR (Oregon)

PA (Pennsylvania)

RI (Rhode Island)

SC (S. Carolina)

SD (S. Dakota)

TN (Tennessee)

TX (Texas)

UT (Utah)

VT (Vermont)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VA (Virginia)

WA (Washington)

WV (W. Virginia)

WI (Wisconsin)

WY (Wyoming)

AB (Alberta)

BC(British Columbia)

MB (Manitoba)

NB (New Brunswick)

NF (Newfoundland)

NS (Nova Scotia)

PE (Prince Edward I)

ON (Ontario)

QC (Quebec) Total

SK (Saskatchewan)

 

 

 

 

 

 

 

 

 

 

 

 

 

# axles:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

III. Need Month Tab?

Yes

No Temporary Cab Card?

Yes

No

1.2.

Trans Unit Number Type

*

3.

Vehicle Identiication Number (VIN)

4.

Vehicle

Make

5.

Model

Year

6.

Vehicle Color

7.

Fuel

Type

**

8.

Unladen Weight

9.

#of Axles/ Seats

10.

Taxable Value

11.

Purchase Price

(Cannot be Zero)

12.

13.

Purchase or Lease

Colorado Title Number

Date

 

 

 

14.

Owner/Operator (if different than registrant)

15.

US DOT # Responsible

for Safety

16.

17.

Is the

FEIN/SSN per

carrier

Vehicle Responsible

responsible

for Safety

for safety

 

changing?

 

Y/N

 

 

 

18.19.

HVUT EMIS

20.

Miles

(if unit

traveled

9,999 miles or less)

21.

New

Plate

I certify that I am familiar with the federal motor carrier safety regulations and/or federal hazardous materials regulations. The undersigned, under oath, swears under penalty of perjury that the information furnished in this application and the attached schedules is true and correct.

Owner or Agent Signature

Title

Date

* A=ADD, C=Correction, D=Delete, D/T=Delete/Transfer, R=Regroup

** B=Biodiesel, C=Comp. Natural Gas, D=Diesel, E=Plug-in Electric, F=Hybrid Electric, G=Gas, H=Hydrogen, M=Methanol, N=None, O=Other, P=Propane, T=Ethanol, X= Hydraulic Hybrid, Y=Liqueied Petroleum Gas, Z=Liqueied Natural Gas

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Schedule B

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IRP Account #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IV. IRP Mileage Schedule & Recap Schedule B (Complete only 1 schedule B per leet)

 

 

 

 

 

 

 

 

 

 

List mileage for each jurisdiction in which the leet traveled July 1, through June 30. Please check one of the following:

Actual Mileage

Estimates (I have no actual miles)

 

 

 

Jurisdiction

Actual Mileage

Jurisdiction

Actual Mileage

Jurisdiction

Actual Mileage

Jurisdiction

Actual Mileage

 

Jurisdiction

Actual Mileage

Jurisdiction

Actual Mileage

Jurisdiction

Actual Mileage

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AL (Alabama)

 

FL (Florida)

 

ME (Maine)

 

NV (Nevada)

 

 

 

OR (Oregon)

 

VA (Virginia)

 

NF (Newfoundland)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AK (Alaska)

 

GA (Georgia)

 

MD (Maryland)

 

NH (New Hamp.)

 

 

PA (Pennsylvania)

 

WA (Washington)

 

NS (Nova Scotia)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AZ (Arizona)

 

ID (Idaho)

 

MA (Mass.)

 

NJ (New Jersey)

 

 

RI (Rhode Island)

 

WV (West Virginia)

 

NT (Northwest Terr.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AR (Arkansas)

 

IL (Illinois)

 

MI (Michigan)

 

NM (New Mexico)

 

 

SC (S. Carolina)

 

WI (Wisconsin)

 

PE (Prince Edward I)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CA (California)

 

IN (Indiana)

 

MN (Minnesota)

 

NY (New York)

 

 

SD (S. Dakota)

 

WY (Wyoming (Y/N)

 

ON (Ontario)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CO (Colorado)

 

IA (Iowa)

 

MS (Mississippi)

 

NC (N. Carolina)

 

 

TN (Tennessee)

 

AB (Alberta)

 

QC (Quebec)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CT (Connecticut)

 

KS (Kansas)

 

MO (Missouri)

 

ND (N. Dakota)

 

 

 

TX (Texas)

 

BC (British Colum.)

 

SK (Saskatchewan)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DE (Delaware)

 

KY (Kentucky)

 

MT (Montana)

 

OH (Ohio)

 

 

 

UT (Utah)

 

MB (Manitoba)

 

YT (Yukon)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DC (Dist. of Col.)

 

LA (Louisiana)

 

NE (Nebraska)

 

OK (Oklahoma)

 

 

 

VT (Vermont)

 

NB (New Brunswick)

 

MX (Mexico)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mileage Reporting Period

 

 

It is required that you write in your mileage reporting period (to the right) for the actual miles that were reported in SECTION IV:

 

July 1 Year

 

 

June 30 Year

 

 

Motor vehicle insurance or operator's coverage is compulsory in the State of Colorado. Proof of insurance is required prior to issuance of a registration. Non-compliance with this requirement is a misdemeanor trafic offense. Pursuant to 42-4-1409, C.R.S., the penalties for failure to have motor vehicle insurance coverage is a Class 1 Misdemeanor Trafic Offense punishable by a mandatory minimum ten days imprisonment, or three hundred dollar ine, or both or a mandatory maximum one year imprisonment, or one thousand dollar ine, or both shall be imposed by section 42-4-1701(3)(a)(II)(A), C.R.S.; and

a.A minimum mandatory ine of not less than ive hundred dollars or greater if imposed by the court; and

b.At the discretion of the court, not less than forty hours of community service, subject to the provisions of section 18-1.3-507, C.R.S.

c.A second or subsequent conviction within a period of ive years following a prior conviction, a minimum mandatory ine of not less than one thousand dollars. After obtaining a registration, you will be required to sign an afirmation clause indicating compliance with insurance requirements.

Unless a person waives his or her conidentiality, the information contained in the person’s motor vehicle record shall not be used for any purpose other than a purpose authorized by law, pursuant to

C.R.S. 42-2-121 (4)(a).

Printed name of Owner/Agent as it Appears on Identiication

Secure and Veriiable ID of Owner/Agent: Colorado DL Colorado ID Other

ID #

Expires

Date of Birth

The undersigned witness afirms that the owner of the vehicle identiied in this document presented the identiication described above.

Witness Signature

Date

I Certify That I Am Familiar With The Federal Motor Carrier Safety Regulations And/Or Federal Hazardous Materials Regulations. The Undersigned, Under Oath, Swears Under Penalty Of Perjury That The Information Furnished In This Application And The Attached Schedules Is True And Correct.

Owner or Agent Signature

Title

Date

Mail To Colorado Department of Revenue: P.O. Box 173350 Denver, CO 80217-3350

Telephone: (303) 205-5608

Fax: (303) 205-5981

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