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Get CO DR 2393 2009

DR 2393 06/24/09 Colorado Department of Revenue division of Motor Vehicles title section www. colorado. gov/revenue statement of repossession This form has been combined to include the DR 2412 Statement of Repossession DR 2417 Certificate of Extension of Chattel Mortgage DR 2004 Floor Plan Declaration Reverse side Lienholder name Date of lien Amount of lien Agents name Date received Filing Number County filed in Delinquent date Possession date Vehicle Identification Number VIN Year Make Body Model I certify under penalty of perjury in the second degree that the above Chattel Mortgage is in arrears and lienholder/agent is in possession of the vehicle. DR 2393 06/24/09 Colorado Department of Revenue division of Motor Vehicles title section www. colorado. gov/revenue statement of repossession This form has been combined to include the DR 2412 Statement of Repossession DR 2417 Certificate of Extension of Chattel Mortgage DR 2004 Floor Plan Declaration Reverse side Lienholder name Date of lien Amount of lien Agents name Date received Filing Number County filed in Delinquent date Possession date Vehicle Identification Number VIN Year Make Body Model I certify under penalty of perjury in the second degree that the above Chattel Mortgage is in arrears and lienholder/agent is in possession of the vehicle. Agent Signature Date Certification of extension of chattel mortgage C. R*S* 38-29-133 42-6-127 Original amount of lien Date extension filed Amount of secured unpaid debt Title Number Lien extended to Owner appropriate county. Signature floor plan declaration his Floor Plan Declaration must be accompanied by all documents of ownership T Manufacturer s Statement of Origin or Title properly assigned to defaulting dealer. If the lienholder is a licensed Colorado dealer they may transfer this vehicle using a Colorado Dealer s Bill of Sale DR 2407. before transferring ownership* this is to declare that is the owner and holder of a note secured by a chattel mortgage executed on against the following dealer Dealer s Name Dealer Number the note and chattel mortgage is a valid and existing lien against the vehicles held under agreement the following described motor vehicle is included in that agreement in accordance with the provisions of the chattel mortgage the undersigned has taken possession of the above described vehicle and the vehicle is now in his/her possession* accurate to the best of my knowledge. gov/revenue statement of repossession This form has been combined to include the DR 2412 Statement of Repossession DR 2417 Certificate of Extension of Chattel Mortgage DR 2004 Floor Plan Declaration Reverse side Lienholder name Date of lien Amount of lien Agents name Date received Filing Number County filed in Delinquent date Possession date Vehicle Identification Number VIN Year Make Body Model I certify under penalty of perjury in the second degree that the above Chattel Mortgage is in arrears and lienholder/agent is in possession of the vehicle. Agent Signature Date Certification of extension of chattel mortgage C. R*S* 38-29-133 42-6-127 Original amount of lien Date extension filed Amount of secured unpaid debt Title Number Lien extended to Owner appropriate county. .

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