SIMI VALLEY POLICE DEPARTMENT 

Using this form, Simi Valley residents can register a bicycle with the Simi Valley Police Department. If the bike is lost or stolen, this registration may aid police in locating your bicycle.

Please enter the bicycle owner's information. If the owner is a child, phone numbers and email should be that of a parent or guardian.  Required fields are marked with an asterisk. Incomplete information may prevent SVPD staff from completing the registration process. 

You will receive a copy of the information at the email address submitted with this form.  If you sell or recycle (throw away) the registered bicycle please remember to contact SVPD at 805-583-6950 and request removal of the bike registration information from the SVPD Records system.

1

 Bicycle Owner Name

 *

Bicycle Owner Name

First Name & MI

Last Name

Date of Birth

2

 Gender/Sex

 *

Gender/Sex

Male

Female

3

Bicycle Information

 *

Bicycle Information

Make	Model	Color
Wheel Size (Inches)	$ Value	Number of Speeds
Serial No.

4

Bicycle Type

 *

Bicycle Type

BC - Beach Cruiser	MC - Motorcross/BMX	MT - Mountain	RC - Racing
TA - Tandem	TO - Touring/Road	TR - Tricycle	Unicycle
OT - Other If other, type text here.

5

Bicycle Style

 *

Bicycle Style

B - Boy's

G - Girl's

M - Men's

U - Unisex

W - Women's

6

Unique Markings/Distinctive Accessories or General Remarks

Unique Markings/Distinctive Accessories or General Remarks

7

Bicycle Owner Address and Contact Information

 *

Bicycle Owner Address and Contact Information

House Number	Street Name	Home Phone#ext.
Cell No.ext.	Email

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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