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UMASS POLICE BICYCLE REGISTRATION

Please fill out this form as completely as possible. The more information that is provided, the more likely it will
be that your bicycle will be able to be recovered in the event that it is lost/stolen.
TODAYS DATE:__________________________

OWNER INFORMATION:
LAST NAME:__________________________________________ FIRST NAME:_________________________________________
ADDRESS:____________________________________________________________________________________________________
DATE OF BIRTH:________________________________________PHONE #:_______________________________________________
*EMAIL:_____________________________________________________________________________________________________
*You will receive your registration confirmation and registration number via e-mail

BICYCLE INFORMATION:
MAKE:________________________________________

MODEL:__________________________________________

COLOR:_______________________________________ # of SPEEDS:_________________________________________
WHERE/WHEN PURCHASED:___________________________________________________________________________
APPROX VALUE:__$__________________________________________________________________________________
*SERIAL NUMBER:____________________________________________________________________________________
* WHERE IS MY BIKES SERIAL NUMBER?
The majority of serial numbers are located under the bottom bracket where the two pedal cranks meet. Simply turn your bike upside down and record the number. If its
not there, use the diagram to help you check the most common locations. The best chance at recovering a stolen bicycle is having a registered serial number.

underside of crank
headset
rear stays
seat downtube next to crank
top of crank

DISTINGUISHING FEATURES (scratches, stickers, engravings, aftermarket parts, grip tape, etc):

____________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
RETURN THIS COMPLETED FORM TO THE UMASS-AMHERST POLICE DEPARTMENT. YOU WILL RECEIVE A CONFIRMATION AND
REGISTRATION NUMBER VIA E-MAIL ONCE THIS FORM IS PROCESSED.

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