Statement of Purchase Price of Motor Vehicle

DR 0070 (10/02/12) COLORADO DEPARTMENT OF REVENUE Taxpayer Service Division 1375 Sherman Street Denver, CO 80261 revenue

Statement of Purchase Price of Motor Vehicle

Name of Purchaser

Address City

Phone

( )

State

ZIP

Make of Vehicle

Year

Body Type

Vehicle Identification Number (VIN)

Purchase Price

Date of Purchase

Purchase price means the price to the consumer. Reference ?39-26-102(7)(a), C.R.S.

Purchased From

Name

Address City

Phone

( )

State

ZIP

I declare, under penalties of perjury in the second degree, that the purchase price noted above was the total price paid by me for the above vehicle and that there were no other considerations in this matter. I further understand that the Colorado Department of Revenue is authorized to make further inquiries from the selling party and others as to the selling price.

Purchaser's Signature

Date

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