Clovis PD Bike Registration Owner InformationName(Required) First Last Phone(Required)Date of Birth(Required) Month Day Year Email(Required) Home Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Bike InformationBrand(Required)Model(Required)Color(Required)# of Speeds(Required)Date of Purchase MM slash DD slash YYYY Serial #(Required)Other Bicycle Characteristics(Required)Bicycle ReceiptMax. file size: 128 MB.Bicycle PhotoMax. file size: 128 MB.Declare(Required) By signing below, I declare under penalty of perjury that I am over 18 years of age and all above information is correct and I am the legal owner of this bicycle. Signature(Required)