DR 2643 07/25/06 COLORADO DEPARTMENT OF REVENUE DIVISION OF MOTOR VEHICLES DRIVER CONTROL 303 205-5613 AFFIDAVIT OF ENROLLMENT LEVEL II DRUG AND ALCOHOL EDUCATION AND TREATMENT THIS SECTION TO BE COMPLETED AND RETURNED TO THE DMV DRIVER CONTROL SECTION Name Date of Birth Colorado PIN Date of Admission Agency Name Agency ID Track Assigned Estimated Date of Completion Signature of Authorized Staff Member Date 1. As a condition for the reinstatement of driving privileges I must complete a Level II alcohol and drug education and treatment program* I understand that the agency providing this service is required to report any noncompliance with the terms of such program and that a report of noncompliance may result in cancellation of my driver s license and denial to reapply until evidence of successful completion of a licensed education and treatment program is provided and any other reinstatement requirements are met. 2. If notice of noncompliance is received by the Division of Motor Vehic....
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How to fill out the Affidavit Of Enrollment online
The Affidavit Of Enrollment is a crucial document required for reinstating driving privileges after completing a Level II drug and alcohol education and treatment program. This guide provides clear, step-by-step instructions on how to complete this form online, ensuring that users can navigate the process smoothly.
Follow the steps to complete the Affidavit Of Enrollment
- Click ‘Get Form’ button to obtain the Affidavit Of Enrollment and open it in the online editor.
- Fill in your name in the designated field. Ensure that the name matches your official identification documents.
- Enter your date of birth. Use the format required by the form, typically MM/DD/YYYY.
- Provide your Colorado PIN in the appropriate section. This number is vital for identification purposes.
- Indicate your date of admission to the Level II program. Be accurate to avoid any confusion.
- Choose the agency name that is providing your Level II education and treatment program. This information is crucial for reporting purposes.
- Insert the agency ID number. This identifier helps confirm the agency's legitimacy and its registration status with the DMV.
- Select the track assigned to you in the education program. This information helps categorize your treatment.
- Estimate your date of completion for the program. If unsure, consult with your treatment provider for guidance.
- The authorized staff member from the treatment agency must sign in the designated area, along with the date of signing.
- As the applicant, sign and date the form where prompted to confirm the truthfulness of the information provided.
- Once all fields are completed, review the document for accuracy. Make any necessary adjustments before proceeding.
- Save the changes made to the form. You may also have options to download, print, or share the completed Affidavit Of Enrollment.
Complete your Affidavit Of Enrollment online today to ensure a smooth reinstatement process for your driving privileges.
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Get answers to your most pressing questions about US Legal Forms API.
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Per 24 P.S. § 13-1302, a person who knowingly provides false information in the above statement for the purpose of enrolling a child in a school district for which the child is not eligible commits a summary offense and shall, upon conviction for such a violation, be sentenced to pay a fine of no more than three ...
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Every child, being a resident of any school district, between the ages of six (6) and twenty-one (21) years, may attend the public schools in his district, subject to the provisions of this act.
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Required Enrollment Documentation Proof of the child's age. ... Immunizations required by law. ... Proof of residency. ... Parent Registration Statement. ... Home Language Survey.
Can a non custodial parent enroll a child in school in Pennsylvania?
The Pennsylvania School Code mandates that school officials are to accept a sworn statement (such as an Affidavit) by the non-parent caregiver that affirms the above requirements. The sworn statement is acceptable proof for the school district to enroll the child living in the non-parent caretaker's home.
Can you live in one school district and go to another in Pennsylvania?
There are many different public-school alternatives that you can explore. Additionally, through open enrollment, students are able to attend schools that are outside of the district they reside in, as long as it's approved by the district that's receiving them.
What is by pa public school code section 24 ps 13-1302?
“When a resident of any school district keeps in his/her home a child of school age, not his/her own, supporting the child gratis as if the child was his/her own, such child shall be entitled to all free school privileges ed to resident school children of the district.
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