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2. Owner First Name*
3. Owners Last Name*
5. Street Address*
6. City*
7. Zip Code*
9. Phone Number*
11. Email Address*
15. Bike Brand*
16. Bike Model
18. Year
19. Color*
21. Serial Number*
23. Special Characteristics
25. Bring bike to police department to receive ID tag and complete registration. *

    1. I agree to bring my bike to the SSLPD at 2835 South Main St. with in the next ten days Mon-Thurs from 9-5 pm to complete registration.
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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field