DR 2395 (09/17/21)
COLORADO DEPARTMENT OF REVENUE
Division of Motor Vehicles
Title Section
DMV.Colorado.gov
Application For Title and/or Registration
C.R.S. 42-3-105, 42-3-304(25)(c), 42-6-107, 42-6-116, 42-6-117
Any Alteration or Erasure may Void this Document
Vehicle Identication Number (VIN)
Fuel Type*:
*If electric, is it plug-in electric?
Yes No
Year Make Body Model Color CWT Off-Highway Vehicle
Yes No
Snowmobile
Yes No
Dealer # Date Purchased Commercial Use
Yes No
MSRP Size (W x L) Bus Cap.
Adult Juvenile
Legal Name(s) as it Appears on Identication*
and Address of Owner(s) or Entity
* DR 2421 Attached
Lease
Buy-Out
Yes No
Legal Name(s) as it Appears on Identication
and Physical Address of Lessee
Indicate Alternate Address Here if The Registration Renewal Should be Sent to a Different Address
First Lienholder Name and Address or ELT E- Number Second Lienholder Name and Address**
Lien Amount Lien Amount
Indicate Alternate Address Here if The Title Should be Sent to a Different Lienholder Address Indicate Alternate Address Here if The Title Should be Sent to a Different Lienholder Address
*
DR 2421 Statement of One in the Same is required when the owners name on the Secure and Veriable ID differs from the owners name on the application/title.
**If more than two lienholders, please attach separate documentation.
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-compli-
ance with this requirement is a misdemeanor trafc offense. Pursuant to 42-4-1409, C.R.S., the penalties for failure to have motor vehicle insurance coverage is a
Class 1 Misdemeanor Trafc Offense punishable by a mandatory minimum ten days imprisonment, or three hundred dollar ne, or both or a mandatory maximum
one year imprisonment, or one thousand dollar ne, or both shall be imposed by section 42-4-1701(3)(a)(II)(A), C.R.S.; and
a. A minimum mandatory ne of not less than ve 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 ve years following a prior conviction, a minimum mandatory ne of not less than one thousand dollars.
After obtaining a registration, you will be required to sign an afrmation clause indicating compliance with insurance requirements.
Unless a person waives his or her condentiality, 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).
I certify, under penalty of perjury in the second degree, that the above information is true and accurate to the best of my knowledge.
Owner or Agent Signature Date
Printed name of Owner/Agent as it appears on Identication:
Secure and Veriable ID of Owner/Agent:
Colorado DL Colorado ID Other:
ID# Expires DOB
The undersigned witness afrms that the named owner of the vehicle identied in this document presented the identication described above.
Witness Signature Date
County Use Only (Dealers/Lienholders: Do Not Write Below this Line)
Previous Title Number Title Number
Date Accepted Purchase Price Odometer Reading & Indicator GVWR Fleet # Unit #
First Lienholder # Second Lienholder #
Lien File No. Lien Amount Maturity Date Date of Lien Lien File No. Lien Amount Maturity Date Date of Lien
Taxes Paid: Filing Fees:
Additional Comments:
________________________________________________________________________________________________________________________
___________________________________________________________________________________ Clerks Initials __________________________
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DR 2395 (09/17/21)
COLORADO DEPARTMENT OF REVENUE
Division of Motor Vehicles
Title Section
DMV.Colorado.gov
State Of Colorado
Joint Tenancy with Rights of Survivorship
Acknowledgement of Intent
C.R.S. 38-11-101
Any Alteration or Erasure may Void this Document
To create joint tenancy with rights of survivorship, there must be specic language declaring such intent, signed under
penalty of perjury in the second degree by all owners. This form is only applicable to multiple owners.
Joint Tenancy with rights of Survivorship is dened as: A form of legal co-ownership of property (also known as
survivorship). At the death of one co-owner, the surviving co-owner becomes sole owner of the property. Transfer of
ownership requires copy of death certicate and signature of survivor.
Tenancy in Common is dened as: The equal or unequal holding of property by two or more persons. At the death of one
co-owner, the deceased share of the property goes to his/her estate and is to be divided according to his/her will or the law
in the absence of a will. Transfer of ownership requires documents appointing a personal representative for the decedent.
Vehicle Identication Number Year Make. Model
Owner One
I _________________________________ (print name) request the Colorado Certicate of Title for the Vehicle
described above be issued in:
Joint Tenancy With Rights of Survivorship Tenancy in Common
Per C.R.S. 42-6-116; I certify under penalty of perjury in the second degree that the above information is true and
correct to the best of my knowledge.
Owners Signature Date
Owner Two
I _________________________________ (print name) request the Colorado Certicate of Title for the Vehicle
described above be issued in:
Joint Tenancy With Rights of Survivorship Tenancy in Common
Per C.R.S. 42-6-116; I certify under penalty of perjury in the second degree that the above information is true and
correct to the best of my knowledge.
Owners Signature Date
Owner Three
I _________________________________ (print name) request the Colorado Certicate of Title for the Vehicle
described above be issued in:
Joint Tenancy With Rights of Survivorship Tenancy in Common
Per C.R.S. 42-6-116; I certify under penalty of perjury in the second degree that the above information is true and
correct to the best of my knowledge.
Owners Signature Date
Owner Four
I _________________________________ (print name) request the Colorado Certicate of Title for the Vehicle
described above be issued in:
Joint Tenancy With Rights of Survivorship Tenancy in Common
Per C.R.S. 42-6-116; I certify under penalty of perjury in the second degree that the above information is true and
correct to the best of my knowledge.
Owners Signature Date
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