Form DR 2717 template
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Evidence of Insurance
This document is a sworn statement certifying an individual's auto insurance coverage, as required for driving privilege reinstatement in Colorado. The person named in the document confirms having a policy with a liability coverage of $25,000/$50,000 for bodily injury and $15,000 for property damage. Details include name, address, case number, driver's license number, date of birth, phone number, insurance company name, address, policy number, and period.
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