C.R.S. § 13-27-106

An unsworn declaration under this article 27 must be in substantially the following form: I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the -------- day of --------, --------, (date)(month)(year) at --------------------------- ------------------ (city or other location, and state or country) ---------------------------- (printed name) ---------------------------- (signature)