Waste Tire Application for Certificate of Registration (WT-1)

Do not use this form for registration renewal.
Only retailers that sell new tires must collect and remit waste tire fees.
Registration category *
Is mailing address the same as street address?
Type of registration (Check all that apply) *
* These registration categories require establishment of financial assurance prior to application submittal and approval.
Do you sell new motor vehicle or trailer tires?
(Only retailers that sell new tires must collect/remit waste tire fees.)
Please choose your method of waste tire fee payment. *
Do you haul waste tires for other businesses and customers? (Choose “No” if you only haul waste tires for your business, and you do not haul/pick up waste tires from other businesses or customers). *
Please select the regions in which you provide service as a waste tire hauler:
This is a map of the waste tire haler regions. Please contact cdphe.hmwastetires@state.co.us to find out which region your county is in.
When you hit Submit, a copy of the completed form will be sent as an attachment to the contact person's email address and you will be re-directed to the waste tire web page.