PLEASE PRINT NEATLY
1.LAST NAME
2. FIRST NAME
5. ADDRESS
3. MI
6. CITY
 BMX
 ROAD
 MOUNTAIN  CROSS
 TANDEM
 REC
10. BRAND
11. BIKE TYPE
14. COLOR
4. DATE OF BIRTH
7. STATE
8. ZIP
9. PHONE #
 BOYS
 GIRLS
 UNISEX
12. MODEL
13. SERIAL #
15. LIGHT 16. WHEEL 17. SPEED
18. MISCELLANEOUS #
DECEMBER 31, 2017
19. LICENSE # / REG #
20. REGISTRATION DATE
21. EXPIRATION DATE
22. OTHER NOTABLE DESCRIPTION ON BICYCLE
Manitowoc Police Dept., Bicycle Registration Application
Name File = White Copy
License = Yellow Copy
Owners Receipt = Pink Copy
When completing this form, please print neatly. It is important to obtain all complete and correct information
when registering bicycles. Bring the completed form to the Manitowoc Police Dept. 910 Jay St., along with
$2.00 for the 6-year registration sticker. The bicycle will then be registered.
1. LAST NAME – Print last name. If a child, list the child’s last name.
2. PROPER or FULL FIRST NAME – Print first name. If a child, list the child’s first name,
(example Proper Name: William not Bill, Daniel not Dan, Samantha or Samuel not Sam).
3. MI – Print middle initial. If a child, list the child’s middle initial.
4. DATE OF BIRTH – Print date-of-birth, (example 10-13-2000). If a child, list the child’s date-of-birth.
5., 6., 7., 8., ADDRESS, CITY, STATE, ZIP – List the home address, city, state and zip code.
9. PHONE – Print the phone number. If a child, list the child’s phone number.
10. BRAND – Print the brand name of the bicycle manufacturer, i.e. Schwinn, Huffy, Murray, Pacific, Magna, Dyno, etc.
11. BIKE TYPE – Select the type of the bicycle, i.e. BMX, Mountain, Tandem, Road, Cross, Recumbant. (see back for
example).
12. BIKE MODEL – Select the model of the bicycle, i.e. Boys, Girls, Unisex.
13. SERIAL NUMBER – Print the serial number of the bicycle. Serial numbers are located in various places on a
bicycle, see back of this page, for suggestions.
14. COLOR – Print the main two colors if appropriate of the bicycle. If Multi colored list MCL.
15. LIGHT – Answer Y (yes) or N (no), if bicycle has an attached light.
16. WHEEL SIZE – Print the wheel size of the bicycle, i.e. 12 (12 inch), 27 (27inch), etc. Located on the tire.
17. SPEED – Print the speed of the bicycle, i.e. 1 (1 speed), 5 (5 speed), 18 (18 speed), etc.
18. MISCELLANEOUS NUMBER - Any number other than the serial number which may identify the bicycle as being
specific to the registering owner.
19., 20., 21., DO-NOT FILL IN- WILL BE ASSIGNED WHEN REGISTERING BICYCLE
AT THE MANITOWOC POLICE DEPARTMENT.
22. OTHER NOTABLE DESCRIPTION ON BICYCLE – Print any specific description of the bicycle, i.e. Basket on
front, Tassels hanging from handle bars, etc.
Serial number
under seat &
on rear drop
outs.
Serial
number front
& side of
head tube.
Serial number
front & side of
head tube.
Serial number
under seat &
on rear drop
outs.
Wheel size
located on
tires.
Serial number
top & bottom
of crank post.
ROAD
Serial number
under seat post
& on rear drop
outs.
Serial number
top & bottom of
crank post.
MOUNTAIN
Serial number
front & side of
head tube.
Serial number
under seat post
& on rear drop
outs.
Serial
number front
& side of
head tube.
Wheel size
located on
tires.
Serial number
top & bottom of
crank post.
Serial number
top & bottom of
crank post.
CROSS
BMX
PLEASE PRINT NEATLY
Serial
number
under seat
post & on
drop outs.
Serial
number front
& side of
head tube.
Citizen
John
1.LAST NAME
1234 S. 15th St.
6. CITY
Schwinn
WI
/
Y
54220 683-4472
X BOYS
 GIRLS
 UNISEX
11. BIKE TYPE
14. COLOR
4. DATE OF BIRTH
7. STATE
X BMX
 ROAD
 MOUNTAIN  CROSS
 TANDEM
 REC
10. BRAND
10/13/2000
3. MI
Manitowoc
5. ADDRESS
Blue
Q.
2. FIRST NAME
12. MODEL
20
8. ZIP
9. PHONE #
X1234567
13. SERIAL #
1
15. LIGHT 16. WHEEL SIZE 17. SPEED 18. MISCELLANEAUS #
DECEMBER 31, 2017
19. LICENSE # / REG #
TANDEM
Serial number
top & bottom of
crank post.
20. REGISTRATION DATE
21. EXPIRATION DATE
Has pegs on rear wheel
22. OTHER NOTABLE DESCRIPTION ON BICYCLE
Manitowoc Police Dept., Bicycle Registration Application
Name File = White Copy
License = Yellow Copy
Owners Receipt = Pink Copy