Affidavit Of Liability And Guardianship printable pdf download

Affidavit Of Liability And Guardianship

DR 2460 (04/24/07)

COLORADO DEPARTMENT OF REVENUE

AFFIDAVIT OF LIABILITY AND GUARDIANSHIP

DIVISION OF MOTOR VEHICLES

(C.R.S. 42-2-108 and 42-2-109)

DRIVER LICENSE SECTION

Must be signed in the presence of a Motor Vehicle employee or Notary Public

Minor's First Name

Middle Name

Last Name

Date of Birth

● I/We understand by signing this form I/we assume liabilities of the above minor driving a motor vehicle, and

● I/We understand my/our signatures may be withdrawn upon written request and the minor's license/permit will be cancelled.

Mother

Signature of Parent or Guardian or Person Assuming Liability

Guardian*

Other*

Father

Signature of Parent or Guardian or Person Assuming Liability

Guardian*

Other*

Motor Vehicle Employee

Date

Notary Public

Subscribed and sworn before me this ___________ day of ______________________ , 20 __________ ,

in the State of Colorado, County of ________________________________________________________ .

My commission expires ___________________________

Signature of Notary Public _______________________________________________________________

* Court or Power of Attorney documents presented: ________________________________________

By signing this form, I / We give our consent as Parent(s) / Guardian(s), for the above named Minor

to be designated as an Organ / Tissue Donor

Seal

YES

Affidavit Of Liability And Guardianship