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2. Name
3. Email Address
5. Address
7. City
8. State
9. Zip Code
11. Phone Number
13. Bicycle Serial Number
15. Color of Frame
17. Frame Type

    1. Boys
    2. Girls
19. Make
21. Model
23. Type of Bike (mountain bike, ten speed, etc.)
25. Frame Size
27. Wheel Size
29. Submission

    Authorization: By clicking "submit" on this form I hereby authorize the action requested and/or police use of the information supplied. I certify that all information as entered is true and correct. I am aware that by submitting this form, my Internet IP address will become available to the Wethersfield Police Department. This IP address can and will be traced if this form is submitted unlawfully.

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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

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