Form Dr 9596 - Gaming License Renewal Application Form Page 2
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required forms of identification
You must submit one of the following forms of identification to obtain an individual gaming license in
Colorado because a gaming license is considered a public benefit. You must also provide an additional
government issued photo identification if your selected form does not contain a photograph. If you are
mailing in your application, submit photocopies of the forms and bring the original documents when ob-
taining your license ID badge. Walk-in applicants must have the original document(s) in their possession.
Please check the one form of identification being PROVIDED:
‰
Valid Colorado Driver’s License or ID Card
‰
U.S. Military Card or Military Dependent’s Identification Card
‰
U.S. Coast Guard Merchant Mariner Card
‰
Native American Tribal Document
‰
Valid Driver’s License or Identification Card bearing Applicant’s photograph issued by any of the U.S. states except:
Hawaii, Illinois, Maryland, Nebraska, New Mexico, Utah, or Washington
‰
A Valid Driver’s License or Identification Card bearing Applicant’s photograph issued by a state listed above that indicates
on it that it is “enhanced.”
‰
A Valid Driver’s License or Identification Card bearing Applicant’s photograph issued by a state listed above, along with an
original certified birth certificate.
‰
United States passport, except for “limited” passports issued for less than five years
‰
Certificate verifying naturalized status issued by an authorized agency of the United States bearing Applicant’s intact photo
graph impressed with the raised embossed seal of the issuing agency
‰
Certificate verifying United States citizenship issued by an authorized agency of the United States bearing Applicant’s intact
photograph impressed with the raised embossed seal of the issuing agency
‰
Unexpired Foreign Passport bearing an unexpired “Processed for I-551” stamp or with an attached unexpired “Temporary
I-551” visa
‰
Unexpired Foreign Passport accompanied by an “I-94” indicating a specific future “until” date
‰
“I-94” with refugee or asylum status
‰
Unexpired “Resident Alien” card, “Permanent Resident” card, “Temporary Resident” card, or “Employment Authorization” card
‰
Other document as identified in 1 CCR 201-17, Rules for Evidence of Lawful Presence. These rules are available online at
the Department of Revenue’s website and are available at each Division office.
If you do not have any of the forms of identification above, a waiver program exists through the Department
of Revenue for persons with health problems, lack of permanent physical address in Colorado or lack
of sufficient documentation. Waiver applicants must go to a designated driver license office listed on the
waiver form.
I have read and understand all the information stated above.
Date
Applicant’s Printed Name
Signature
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