Dr 2212a 2026

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The document is a Colorado Road and Community Safety Act Affidavit (DR 2212A) used by applicants to affirm their residency status in Colorado and their intention to be lawfully present in the United States. It requires personal information such as the applicant's name, date of birth, address, and place of birth, along with a signature affirming the truthfulness of the provided information under penalty of perjury.

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Click ‘Get Form’ to open the dr 2212a in the editor.
Begin by entering your full legal name in the designated field. Ensure that it matches your official identification.
Next, input your date of birth in the format MM/DD/YY. This is crucial for verifying your identity.
Fill in your current resident address, including street, city, state, and ZIP code. Accuracy here is important for residency verification.
Provide your phone number in the specified format. This will be used for any necessary follow-up communication.
Indicate your place of birth by selecting the city and state from the dropdown menus provided.
Choose one of the affirmation statements regarding your residency status and ensure you understand its implications.
Finally, sign and date the form at the bottom to affirm that all information is true and accurate before submitting.

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