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Bike Theft Report
Step
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2
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Demographics and Contact Information
Where did the theft occur?
*
Type in name or physical address. If crime occurred off-campus, you must contact the agency responsible for the jurisdiction in which the crime occurred.
I am a
*
Victim
Witness
Other
Name
*
First
Middle
Last
Note: if you don’t have a middle name, please enter “none.” Something has to be entered in the field for the form to submit.
Date of Birth
*
Month
Day
Year
Race
*
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Other
Ethnicity
*
Hispanic or Latino
Not Hispanic or Latino
Gender
*
Male
Female
Other
Phone
*
CSU ID#
Email
Permanent Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
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Aruba
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Austria
Azerbaijan
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Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
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Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
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Cameroon
Canada
Cayman Islands
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Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
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Congo
Congo, Democratic Republic of the
Cook Islands
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Curaçao
Cyprus
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Ethiopia
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Faroe Islands
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Finland
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French Guiana
French Polynesia
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Gabon
Gambia
Georgia
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Ghana
Gibraltar
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Greenland
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Guinea-Bissau
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Korea, Republic of
Kuwait
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Mali
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Nigeria
Niue
Norfolk Island
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Northern Mariana Islands
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Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Local Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Driver License #
Driver License State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michican
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other Country
Theft Window
An accurate theft window assists our department in tracking patterns. Please be as accurate as possible.
Date Bicycle Last Seen
*
MM slash DD slash YYYY
Time Bicycle Last Seen
*
:
Hours
Minutes
AM
PM
AM/PM
Date Noticed Missing
*
MM slash DD slash YYYY
Time Noticed Missing
*
:
Hours
Minutes
AM
PM
AM/PM
Bicycle Information
If you do not have these details and your bicycle is registered with our department, you may call (970) 491-7695 to acquire this information.
Is this bicycle registered with the CSU Police Department?
*
Yes
No
Unsure
Serial Number
CSU Registration Number (if known)
Make
*
Write “Custom” if no specific make or “Unknown” if unknown.
Model
Color(s)
Type
*
Mountain Bike
Road Bike
Cruiser
Hybrid
Other
Fair Market Value
*
Value of bicycle if it were to be sold today.
Was the bicycle locked (secured)?
*
Yes
No
Unknown
Was the CSU-provided lock used to secure the bike?
*
Yes
No
During the 2022-2023 academic year, ASCSU and ATFAB provided funds to allow the CSUPD to purchase one lock per student, while supplies last
If it was a CSU-provided lock, was the bike properly locked with the frame locked to the bike rack?
Yes
No
If not a CSU-provided lock, what type of lock?
*
Cable Lock
U-Lock
Both Cable and U-Lock
Other
Unlocked
Cable includes cable and chain locks. A U-Lock is a solid metal lock in the shape of a “U.”
If not a CSU-provided lock, what is the value?
Value of lock if it were to be sold today.
What was the bicycle locked to?
*
Status of the lock
Lock was gone
Lock was present, but broken
Lock was undamaged
Follow-Up
Officer may use this to contact you for any further information needed.
When is the best time to contact you?
*
Morning
Afternoon
Evening
Preferred method of contact
Email
Phone
Signature
*
First
Last
By signing above, you agree that any form of electronic signature may substitute for the original signature and shall have the same legal effects as the original signature and that the report and information is true to the best of your knowledge.
