Bicycle Retrieval Request Form

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Owner Information

Full Name

Last 4 Digits of GID Number

Email Address

Phone Number

Bicycle Information

Bicycle Make

Bicycle Model

Bicycle Color(s)

Serial Number

Was the bicycle registered with MSUPD

Yes

Decal Number (if yes)

Identifying Features

Last Known Bicycle Location

Date and Time of Pick Up

Additional Comments

All request forms must be submitted by August 31, 2020, and require proof of ownership such as decal number, serial number, receipt of purchase, or a picture. Please email all pictures to [email protected].

Requests without proof of ownership may be denied.

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