Form Dr 2100 - Release Of Liability Form Car Accident
Download a blank fillable Form Dr 2100 - Release Of Liability Form Car Accident in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Dr 2100 - Release Of Liability Form Car Accident with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1DR 2100 (08/31/16)
COLORADO DEPARTMENT OF REVENUE
Division of Motor Vehicles
Driver Control Section, Room 164
PO Box 173350
Denver, CO 80217-3350
Release From Liability
FR Case Number
I (we) release the following person from all claims or liability as a result of the motor
vehicle accident shown below. This release satisfies the requirements of the Financial
Responsibility Act §42-7-301, C.R.S.
Date of Accident
Name of Person Released from Liability
Driver's License Number
Date of Birth
Address
City
State
ZIP
Names of other person(s) involved in this accident having injuries or property damage.
Name
1.
Address
City
State
ZIP
Name
2.
Address
City
State
ZIP
Name
3.
Address
City
State
ZIP
Signatures
No. 1
Date
No. 2
Date
No. 3
Date
Signature of Parent or Guardian of Minor
Date
Seal
Subscribed and affirmed, or sworn to, before me this ______ day of
_____________________ , 20____
in the County of _____________________, State of ________________________.
Notary Signature
Commission Expiration Date
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business