To the Registrar of Titles in the County of .............., and State of Colorado: I, (or we), ............, the undersigned registered owner of the within described real property, do hereby request that said real property and the title thereto be forthwith withdrawn from registration under the terms of this article.
Witness my (or our) hand this .......... day of .........., A.D. 20.....
STATE OF COLORADO | ) |
) | ss. |
County of ..................................... | ) |
The foregoing instrument was acknowledged before me this ............ day of ............, A.D. 20...., by ................
Witness my hand and official seal.
My Commission expires:
.................................
Notary Public.
C.R.S. § 38-36-136