Last Name *:

First Name *:

Student/Staff ID *:

Email Address:

Address:

Phone:

Address 2:

Other Phone:

City:

Zip Code:

Serial Number *:

Bicycle Serial Number Locations

Manufacturer:

Model:

Gears:

Style:

Color:

Accessories or Other Identifying Marks

In case of theft, immediately report the theft to:

UNI Department of Public Safety

30 Gilchrist Hall

(319) 273-2712

Answers to questions or information for crime prevention are available.