Request to Cancel Colorado License Plates
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DCMV 401 4/4/2018
Request to Cancel Colorado License Plates
I/We, ______, request that the following Colorado License Plate/Record be cancelled:
Plate type: ______and Plate number: ______This plate is currently registered to the following vehicle: Year ______Make ______VIN ______
By canceling, I/We acknowledge that any remaining credit from this record is hereby forfeited.
Plates received by county office: Yes ______No ______If above is checked no please explain: ______
I certify, under penalty of perjury in the second degree, that the above information is true and accurate to the best of my knowledge.
Owner 1 Printed Name as it appears on Identification: ______Owner Signature: ______Date: ______
Owner 2 Printed Name as it appears on Identification: ______Owner Signature: ______Date: ______
Owner 3 Printed Name as it appears on Identification: ______Owner Signature: ______Date: ______
Owner 4 Printed Name as it appears on Identification: ______Owner Signature: ______Date: ______