Business Registration And Retail Sales Tax Application Form - 2011 Page 4
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4____________________________________________________________________________________________________________
LAWFUL PRESENCE AFFIDAVIT
(this form only needs to be filled out by applicants who are applying as a sole proprietor)
I,
swear or affirm under penalty of perjury under the laws of the
State of Colorado that (check one):
____ I am a United States citizen, or
____ I am a legal Permanent Resident of the United States, or
____ I am otherwise lawfully present in the United States pursuant to Federal law.
I understand that this sworn statement is required by law because I have applied for a public benefit. I understand that
state law requires me to provide proof that I am lawfully present in the United States prior to receipt of this public benefit.
I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is
punishable under the criminal laws of Colorado as perjury in the second degree under Colorado Revised Statute 18-8503
and it shall constitute a separate criminal offense each time a public benefit is fraudulently received.
Signature
Date
Per HB 06S-1023, you must provide a copy of one of the following IDs.
Colorado Driver’s License
Colorado ID card
Military IDs
Coast Guard mariner document
Native American tribal document
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