
NONRESIDENCE AND MILITARY
SERVICE EXEMPTION FROM SPECIFIC
OWNERSHIP TAX AFFIDAVIT
Incomplete application will not be processed.
C.R.S. 42-3-104(9)
APPLICANT - This form is to be completed when the vehicle owner(s) meet the exemption requirements as listed in C.R.S.
42-3-104(9) and /or the Servicemembers Civil Relief Act and the Military Spouse Residency Relief Act contained in sections
1, 2, and 3, Title 50 App. U.S.C. Only the military individual, servicemember’s spouse, or a lawful agent with power of attorney
Servicemember’s Name or Servicemember’s Spouse’s Name Social Security Number
Colorado Address (Street Address, City and ZIP) County
Colorado Military Installation Servicemember is Assigned to Under Orders Duty Telephone Number
( )
Year Make Body
State Where Vehicle Purchased Date of Purchase State of Legal Residence
under C.R.S. 42-3-104(9), the Servicemembers Civil Relief Act, and the Military Spouse Residency Relief Act. I am
located in Colorado as a result of military service. To support my claim, I further acknowledge that:
I am not a legal resident of the State of Colorado.
I am a member of the Armed Forces of the United States, serving under orders in Colorado or I am the spouse of
a Servicemember serving under order in Colorado.
I am a named owner on the vehicle for which the exemption is being claimed.
This vehicle will not be used in any trade or business in the State of Colorado. Should this vehicle be used as part
of a business, the vehicle will be subject to full payment of all taxes due.
Servicemember - Military ID is required to be presented with this form, copy of orders (issued in the
servicemembers name), and a current leave and earnings statement are required to be attached to this form.
Servicemember’s Spouse or Agent - Copy of orders, leave and earnings statement, and Power of Attorney is
required to be attached to this form. Servicemember’s spouse’s military ID must list the servicemember as the
sponsor.
I certify, under penalty of perjury, that the above statements are true and accurate to the best of my knowledge. The
Department reserves the right to validate the above statements with the military installation and/or servicemembers
Signature Date
Colorado DL Colorado ID Other _____________________________________
ID # Expires DOB
Witness Printed Name Witness Signature
COLORADO DEPARTMENT OF REVENUE
DIVISION OF MOTOR VEHICLES
REGISTRATION SECTION
www.colorado.gov/revenue