SPRINGFIELD POLICE DEPARTMENT
BICYCLE REGISTRATION
PERSONAL INFORMATION
* LAST NAME:
 * FIRST NAME:
* STREET ADDRESS:
APARTMENT
NUMBER:
 * TELEPHONE/CELL NUMBER:
BICYCLE  INFORMATION
* MAKE:
 * MODEL:
* SERIAL NUMBER:
* TYPE:
 * FRAME STYLE:
FRAME SIZE:
 GEARS/SPEEDS:
FRAME COLOR(S):
ACCESSORIES:
"PEGS"
 LIGHTING SYSTEM
 CHILD CARRIER
 MIRROR
* APPROXIMATE VALUE:
 DATE OF PURCHASE:
DO YOU HAVE A BILL OF SALE?
YES
 NO
 GIFT
COMMENTS OR OTHER DESCRIPTION:
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Use the form below to register your bicycle with the Springfield, Vermont Police Department.
Be sure to fill in all the blanks.   Fields marked with an " * " are REQUIRED.
This will assist the Police Department to identify your bike should it be lost or stolen.
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