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Get CO DR 2314 2016

DR 2314 08/31/16 COLORADO DEPARTMENT OF REVENUE Division of Motor Vehicles Driver Control Section Room 164 P O Box 173350 Denver CO 80217-3350 Affidavit of Financial Responsibility FRA Case Number Name Driver s License Number DOB State ZIP Address City Date of Accident In order to reinstate a driver license suspension under the Financial Responsibility Act 42. 7-301 C. R*S* you must acknowledge one of the following statements Please check only one box I certify that I am not responsible for any damages or injuries to any other party as a result of this accident. I understand that if the department receives information that I owe damages my license will be suspended immediately. or I certify that it has been three years since the motor vehicle accident and no action for damages has been instituted within the three years as a result of this accident. I must maintain future proof of liability insurance in the form of an SR 22 for 3 years. Signature Date Subscribed and affirmed or sworn to before me this day of 20 in the County of State Notary Signature Commission Expiration Date. 7-301 C. R*S* you must acknowledge one of the following statements Please check only one box I certify that I am not responsible for any damages or injuries to any other party as a result of this accident. I understand that if the department receives information that I owe damages my license will be suspended immediately. I understand that if the department receives information that I owe damages my license will be suspended immediately. or I certify that it has been three years since the motor vehicle accident and no action for damages has been instituted within the three years as a result of this accident. or I certify that it has been three years since the motor vehicle accident and no action for damages has been instituted within the three years as a result of this accident. I must maintain future proof of liability insurance in the form of an SR 22 for 3 years. Signature Date Subscribed and affirmed or sworn to before me this day of 20 in the County of State Notary Signature Commission Expiration Date. 7-301 C. R*S* you must acknowledge one of the following statements Please check only one box I certify that I am not responsible for any damages or injuries to any other party as a result of this accident. I understand that if the department receives information that I owe damages my license will be suspended immediately. or I certify that it has been three years since the motor vehicle accident and no action for damages has been instituted within the three years as a result of this accident. I understand that if the department receives information that I owe damages my license will be suspended immediately. or I certify that it has been three years since the motor vehicle accident and no action for damages has been instituted within the three years as a result of this accident. I must maintain future proof of liability insurance in the form of an SR 22 for 3 years. Signature Date Subscribed and affirmed or sworn to before me this day of 20 in the County of State Notary Signature Commission Expiration Date. .

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