Dr4679 2026

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The document is an affidavit required by the Colorado Department of Revenue for individuals applying for public benefits. It requires applicants to affirm their citizenship or lawful residency status under penalty of perjury and provides a list of acceptable forms of identification to verify their status. The document emphasizes the legal consequences of providing false information.

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Click ‘Get Form’ to open dr4679 in the editor.
Begin by filling in your name in the 'PRIMARY APPLICANT' section. Ensure accuracy as this is a sworn statement.
Select one of the three options regarding your citizenship status by checking the appropriate box.
If you are not a U.S. citizen, enter your Alien Registration Number in the designated field.
Proceed to the 'SPOUSE, IF MARRIED' section and repeat steps 2-4 for your spouse's information.
Review the acknowledgment statement carefully before signing. This confirms your understanding of the legal implications.
Sign and date both fields for yourself and your spouse if applicable.
Lastly, ensure you attach a copy of an acceptable form of identification as listed in the document.

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