Record information available at Driver License offices and 1881 Pierce St.
All other requests available only at 1881 Pierce St., Lakewood, CO.
I hereby authorize the release of records maintained by the Colorado Department of Revenue, Motor Vehicle Division pursuant to the Driver’s Privacy Protection Act (18 USC 2721) and Colorado law (42-72-204, 42-1-206, 42-3-125 CRS).
Signature ______________________________ Date ____________________________
Date of Birth _______________________ License Number _______________________
Purpose for which records are released ________________________________________
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Company ________________________________________________________________
Address _________________________________________________________________
City ____________________________ State ______ Zip Code ____________________
Signature of Requestor _____________________________________ Date ____________