The Colorado DR 2153 form is an affidavit used by individuals who have experienced identity theft related to their driver's license or identification card. This form must be completed and notarized, then submitted along with a police report to a driver’s license office to apply for a new number. It serves as an official declaration to assist victims in recovering from the impacts of identity theft.
The Colorado DR 2153 form serves as a crucial tool for individuals who have fallen victim to identity theft involving their driver's license or identification card. This affidavit allows victims to officially report the theft and apply for a new license or ID number. To initiate the process, individuals must complete the form, ensuring that it is notarized before submission. The document requires detailed personal information, including the victim's full legal name, date of birth, and social security number, as well as specifics regarding the fraudulent activities that have occurred. Victims must also provide information about their current and previous addresses, along with any law enforcement actions taken, such as police reports filed. Additionally, the form emphasizes the importance of honesty, as providing false information can lead to severe legal consequences. By gathering necessary documentation and signatures, the DR 2153 form facilitates the victim's journey toward regaining their identity and protecting their personal information from further misuse.
DR 2153 (11/13/07)
COLORADO DEPARTMENT OF REVENUE DIVISION OF MOTOR VEHICLES INVESTIGATIONS UNIT
1881 PIERCE STREET, ROOM 136 LAKEWOOD, COLORADO 80214 (303) 205-8383
AFFIDAVIT OF
COLORADO DRIVER'S LICENSE
OR ID THEFT
Take (DO NOT MAIL OR FAX) this completed, notarized form
with a police report to a driver’s license office to apply for a license or ID with a new number (PIN).
VICTIM IDENTIFICATION
Note: Knowingly submitting false information on this form could subject you to criminal prosecution for perjury.
FULL LEGAL NAME
First
Middle
Last
Jr. Sr. III
NAME (IF DIFFERENT FROM ABOVE) WHEN THE EVENTS DESCRIBED IN THIS AFFIDAVIT TOOK PLACE
Jr.
Sr.
III
Date of Birth
Social Security Number
Driver's license or Identification card number (PIN)
CURRENT ADDRESS
Address
State
City
ZIP Code
Beginning date of residence at this address:
Month
Year
ADDRESS (IF DIFFERENT FROM ABOVE) WHEN THE EVENTS DESCRIBED IN THISAFFIDAVIT TOOK PLACE
Beginning and End date of residence at this address:
From:
To:
Current Daytime Telephone Number
Current Evening Telephone Number
HOW THE FRAUD OCCURRED
Check all that apply for items 1-6:
1.I did not authorize anyone to use my name or personal information to seek the money, credit, loans, goods or
services described in this report.
I did not receive any benefit, money, goods or services as a result of the events described in this report.
2.
My identification documents (for example, credit cards, birth certificate, driver's license, Social Security card, etc.) were
3.
stolen
lost on or about _______________________________________________________(month/day/year)
4. To the best of my knowledge and belief, the following person(s) used my information (for example, my name, address, date of birth, existing account numbers, Social Security number, mother’s maiden name, etc.) or identification documents to get money, credit, loans, goods or services without my knowledge or authorization:
Name
Address (if known)
Phone Number(s)
Additional Information
5.I do not know who used my information or identification documents to get money, credit, loans, goods or services without my knowledge or authorization.
6.Additional comments (For example, description of the fraud, which documents or information were used or how the identity thief gained access to your information.)
____________________________________________________________________________________________
_____________________________________________________________ (Attach additional pages as necessary.)
VICTIM’S LAW ENFORCEMENTACTIONS
7.My signature below indicates that I am willing to assist in the prosecution of the person(s) who committed this fraud.
8.My signature below authorizes the release of this information to law enforcement for the purpose of assisting them in the investigation and prosecution of the persons who committed this fraud.
9.(check all that apply) I have reported the events described in this affidavit to the police or other law enforcement
agency. The police
did
did not write a report. Please complete the following:
Agency Number 1
Officer/Agency personnel taking report
Date of report
Report number, if any
Phone number
E-mail address, if any
Agency Number 2
Please indicate the supporting documentation you are able to provide.Attach copies (NOT originals) to the affidavit. Acopy of the report filed with the police or sheriff’s department is attached.
SIGNATURE
I declare under penalty of perjury that the information I have provided in this affidavit is true and correct to the best of my knowledge. I understand that if I give a false statement, my driver's license or identification card may be canceled and denied, in accordance with § 42-2-122, C.R.S. I also understand that if I am convicted of perjury in the first or second degree, the Department shall immediately revoke my driver's license or identification card, in accordance with § 42-2-125, C.R.S.
Knowingly submitting false information on this form could subject you to criminal prosecution for perjury.
Signature__________________________________________________Date signed _____________________________
Subscribed and sworn to before me in the County of _________________________________________, State of Colorado,
this_______________________________________ day of ________________________________, 2 ______________
Notary Public________________________________________________ My commission expires ___________________
The Colorado DR 2153 form is an essential document for individuals who have experienced identity theft related to their driver's license or state ID. Along with this form, several other documents may be necessary to support the application for a new license or ID. Below is a list of these documents, each serving a specific purpose in the process.
Gathering these documents can help streamline the process of obtaining a new driver's license or ID after experiencing identity theft. Each document plays a crucial role in substantiating the claim and ensuring that the victim's identity is protected moving forward.
Colorado Ucc3 - The UCC3 form is used to amend financing statements in Colorado.
Death Certificate Colorado - This form helps to mitigate potential disputes regarding property ownership.
Filling out the Colorado DR 2153 form is a crucial step for victims of identity theft seeking a new driver's license or ID. This process requires careful attention to detail, as accuracy is essential. After completing the form, you will need to submit it in person, along with a police report, to a designated driver's license office.
Once you have completed these steps, you are ready to take the notarized form and police report to a driver's license office. Remember to keep copies of everything for your records. This will help ensure that you can follow up on your application if needed.
The Colorado DR 2153 form shares similarities with the Identity Theft Report, which is often used by victims to document their experience of identity theft. This report serves as an official account that can be provided to creditors and law enforcement. Like the DR 2153, it requires detailed personal information about the victim and specifics about the fraudulent activities. Both documents aim to establish the victim's identity and the circumstances surrounding the theft, facilitating the process of reclaiming their identity and securing new identification.
Another comparable document is the Federal Trade Commission (FTC) Identity Theft Affidavit. This affidavit is designed for victims to report identity theft at the federal level. Similar to the DR 2153, it includes sections for personal identification and a description of the fraudulent activities. The FTC affidavit can be used to create a recovery plan and is often accepted by creditors as proof of identity theft, helping victims to mitigate the damage caused by the crime.
The police report is another document that aligns with the DR 2153. Victims of identity theft are typically encouraged to file a police report to officially document the crime. Like the DR 2153, this report requires a thorough account of the events leading to the theft. Both documents serve as critical evidence for victims when disputing fraudulent charges or accounts, and they can be used in conjunction to strengthen the victim's case against identity theft.
The Affidavit of Fraud is also similar to the DR 2153. This document allows individuals to declare that they have been victims of fraud, detailing the nature of the fraud and the impact it has had on their lives. Like the DR 2153, it requires the victim to provide personal information and a narrative of the fraudulent activities. Both affidavits serve to affirm the victim's claims and assist in legal or administrative processes that may follow the fraud.
Lastly, the Credit Report Dispute Form is akin to the DR 2153 in that it is used by victims to contest inaccuracies on their credit reports stemming from identity theft. This form allows individuals to provide evidence of fraudulent activity, similar to the detailed account required in the DR 2153. Both documents are essential for victims seeking to restore their creditworthiness and prevent further damage from the identity theft incident.
The Colorado DR 2153 form is an affidavit used to report identity theft related to a Colorado driver's license or identification card. It allows victims to apply for a new license or ID number after their personal information has been compromised.
Individuals who believe their driver's license or identification card has been used fraudulently should complete this form. It is essential for victims of identity theft who want to obtain a new license or ID number.
Do not mail or fax the completed DR 2153 form. Instead, take the notarized form along with a police report to a local driver’s license office in Colorado.
You will need to provide personal details such as your full legal name, date of birth, Social Security number, and current address. Additionally, you must describe how the fraud occurred and provide information about any police reports filed.
Yes, the DR 2153 form must be notarized before submission. This step is crucial to verify your identity and the authenticity of the information provided.
If you do not know who used your information, you can indicate this on the form. There is a specific section where you can state that you are unaware of the identity thief.
Yes, you can include additional comments about the fraud on the form. If necessary, attach extra pages to provide a detailed description of the incident.
Providing false information on the DR 2153 form can lead to criminal prosecution for perjury. Additionally, your driver's license or identification card may be canceled or denied.
Attach copies of any supporting documents, including the police report related to the identity theft. Do not send original documents; only copies are required.
You will sign the form, declaring under penalty of perjury that the information provided is accurate to the best of your knowledge. This signature is a legal affirmation of your statements.
When filling out the Colorado DR 2153 form, it is essential to approach the process with care and attention. Here are some important guidelines to follow, as well as some common pitfalls to avoid: