Permit Application | UConn Affiliates Permit Application | UConn Affiliates If you are Faculty, Adjunct Faculty, Staff, Special Payroll or an Affiliated employee and have an active NetID, DO NOT USE THIS FORM. Please log into your parking account on the Parking Portal to purchase a permit. This application is intended to be used by: UConn Affiliates who ARE NOT directly paid by the University and DO NOT have a NetID. UConn faculty, staff, and affiliate permit-holders who want to add or change the vehicle registration information associated with their current permits. Those who work for and drive vehicles registered to other Connecticut state agencies who seek authorization to park those state-registered vehicles on UConn property. Applicant InformationName* First Middle Last Do you know your PeopleSoftID or NetID?*Your PeopleSoftID or NetID will help us expedite the processing of your request. Employee Number NetID I don't have or know either Employee Number NetID Phone*Email* HiddenHome Address Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Primary UConn Campus Affiliation*Select CampusAvery PointHartford - Downtown CampusSchool of LawStamfordStorrs - Depot CampusStorrs - Main CampusWaterburyEmployment Status InformationUniversity Payroll Status* I am a Regular Payroll employee I am a Special Payroll Employee I am a University Affiliate HiddenRegular Payroll Certification Document being submitted:*Newly (re)employed University "Regular Payroll" employee must submit a copy of their Employment Contract with this application using the "Submit" button below. Regular Payroll Applications without proper employment certification cannot be processed.Select document type to be uploadedContract DocumentHiddenRegular Payroll Certification Document Upload (required):Max. file size: 100 MB.HiddenSpecial Payroll Certification Document being submitted:*"Special Payroll" employees include Adjunct Faculty and those whose University employment is arranged by time-limited contracts. Special Payroll employees must submit a copy of either their Appointment Letter or Employment Contract with this application using the "Submit" button below. Special Payroll Application without proper employment certification cannot be processed.Select document type being submittedAppointment LetterContract DocumentHiddenSpecial Payroll Certification Document Upload (required):Max. file size: 100 MB.I am a University Affiliate and my employer is:*"University Affiliates" work at the University but are not directly paid by UConn.Select your employerAlumni Center (UConn Foundation)Barnes & Noble College (Avery Pt.)Barnes & Noble College (Hartford)Barnes & Noble College (Storrs)BMECampus Director, Office of theCT Center for NonviolenceCT Urban Law Initiative (CULI)CT Community Law Center (CCLC)Children & Family Services (Training Grant)Dining ServicesEA QuinnFastenal CompanyMurphy Security (HVD Campus Security)Mystic Aquarium)Project OceanologyProject Oceanology (Part-Time employee)Project Oceanology (Intern)Residence Life - Live-in Staff (Storrs)Residence Life - Live-in Staff (Stamford)Rudd CenterR/V ConnecticutServitiumState Agency Vehicle Overnight AuthorizationTechnology Incubation Program (TIP)UConn FoundationUConn Law School FoundationWaterford Vocational Program (Avery Point)OtherResidence Life: Employee / Partner StatusPlease change the default "Employee" designation if you are the partner of a live-in Residence Life employee. I am a Live-in Residence Life Employee I am the Partner of a Live-in Residence Life Employee Bargaining Unit (if any)*Select bargaining unit if represented...AAUPAFSCME (NP-3)CEUI (NP-2)GEU-UAWPSEC (NP-5)UCPEAPermit Type Requested | Purpose of Submission I am submitting this form to ...*Select from the list ...Purchase a new / my first parking permitRenew my Parking PermitUpgrade or Downgrade my Permit TypeChange vehicle information associated with my current parking permitOther...Please state the reason for your form submission.... Mailing Address* This is also the address to which your physical parking permit will be mailed. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country U.S. Government or State Agency to which the vehicle is registeredSelect Vehicle's AffiliationAdministrative Services, Dept OfAfrican American Affairs CommissionAging, Connecticut Commission onAgricultural Experiment StationAgriculture, Dept OfAttorney General, Office Of TheAuditors Of Public AccountsBanking, Dept OfChild Advocate, Office ofChildren & Families, Dept OfChildren, Commission OnComptroller, Office Of The StateConnecticut Development AuthorityConnecticut Lottery CorporationConsumer Counsel, Office OfConsumer Protection, Dept OfCorrection, Dept OfCriminal JusticeDevelopmental Services, Dept OfDisabilities, Protection And AdvocacyEconomic and Community DevelopmentEducation, Dept OfEducational TechnologyElections Enforcement Commission, StateEmergency Services and Public ProtectionEnergy and Environmental ProtectionEnvironmental QualityEthics, Office of StateFirearms Permit Examiners, Board OfFreedom Of Information CommissionGovernor's OfficeHealth Care Access, Office OfHealthcare Advocate, Office Of TheHigher Education, Office OfHuman Rights And OpportunitiesInsurance DeptJudicial Review CouncilJudicial Selection CommissionLabor DeptLatino & Puerto Rican Affairs,Commission on Legislative ManagementLieutenant Governor, Office Of TheMedical Examiner, Office Of The ChiefMental Health & Addiction Services, Dept OfMilitary Affairs, Office ofMilitary DeptMotor Vehicles DepartmentOTHERPardons And Paroles, The Board OfPolicy And Management, Office OfProbate Court AdministrationProperty Rights, Office Of Ombudsman ForPsychiatric Security Review BoardPublic Defender Services, Division OfPublic Health, Dept OfRevenue Services, Dept OfSecretary Of The State, Office OfSiting Council, ConnecticutSocial Services, Dept OfSoldiers', Sailors', And Marines' FundState LibraryTeachers' Retirement BoardTransportation, Dept OfTreasurer, Office Of The StateUS Geological Survey GroupVeterans' Affairs, Dept OfVictim Advocate, Office Of TheWomen, Permanent Commission On Status OfWorkers' Compensation CommissionWorkforce Competitiveness, Office For"Other" Government or State Agency Name of "other" employer | internship department | etc. Upload scanned copy of Government or State Vehicle registration.Max. file size: 100 MB.Barnes & Noble College Parking Fee Schedule Area 2 - Storrs & Regional Campuses; $138.26/year (2020/21 rate; tax included) Garages - Storrs Campus; $574.29/year (2020/21 rate; tax included) Current Parking Permit TypePlease enter your current type of parking permit. (Area 2, North Garage, CT Conv Ctr, etc.) Permit Type Requested*Select your preferred parking permit type from those listed below. Area 2 (Storrs & Regional campuses) South Parking Garage (Storrs only) EA Quinn Landscaping EA Quinn Landscaping employees working on the UConn Storrs campus are eligible to purchase Area 2 parking permits at a 50% discount. Permit Type Requested*Select your preferred parking permit type from those listed below. Alumni Center Lot (ONLY) South Parking Garage (Storrs) Area 2 (Storrs & Regional campuses) Parking Permit for: Alumni Center Lot (Storrs)UConn Foundation employees (only) are eligible for hangtag permits that authorize parking exclusively on the Alumni Center Lot (Storrs). Please select the following option to apply. Alumni Center Lot - Hangtag Permit Hartford Garage to which access is requested...*Parking capacity in the North Front Street Garage is limited. All applications will be processed in the following order on a first-come-first-served basis: Those with state-issued handicap placards or current "Special" parking permits; Faculty and Professional Staff (full-time), all other employees (full-time), all other applicants. Convention Center Garage North Front Street Garage:NFS Science Center Garage You will be assigned parking privileges in the TARGET garage, located at 21 Broad Street, Stamford, CT, on a space available basis. Access to that facility will be gained using a Access Card provided by Park Inc., who operates that facility. The display of your UConn parking permit is also required. Additional information related to the provision of that Access Card and the finalization of these parking arrangements will be provided to you within a confirmatory email that will be sent to you upon the submission of this form. If the University's parking limit has been reached and TARGET garage parking is unavailable, you will be provided with permit parking in the UConn Stamford surface parking lot located at 1194 Washington Boulevard. Access to the 1194 Washington Boulevard lot authorized by the display of your UConn parking permit and your vehicle's registration number (license plate). You will be assigned parking privileges on the UConn Stamford surface parking lot located at 1194 Washington Boulevard. Access to that facility will be authorized by the display of your UConn parking permit and your vehicle's registration number (license plate). Additional information related the finalization of these parking arrangements will be provided to your within a confirmatory email, which will be sent to you upon the submission of this form. Second Choice of Garage to which access is requested...*Parking capacity in the North Front Street Garage is limited. All applications will be processed in the following order on a first-come-first-served basis: Those with state-issued handicap placards or current "Special" parking permits; Faculty and Professional Staff (full-time), all other employees (full-time), all other applicants. Convention Center Garage Science Center Garage Accessible / handicap parking accommodations are... Those who require accessible / handicap parking accommodations will be required to upload a scanned copy of their state-issued handicap parking placard or UConn documentation of that requirement. UConn employees who do NOT have a state-issued handicap parking plate or placard but would have limitations that you believe warrants assessment and possible accommodation should contact the University's Manager of Injury, Illness & Accommodations, Department of Human Resources, 9 Walters Avenue, U-5075, Storrs, CT 06269 | Phone: (860) 486-2036. Not Required REQUIRED File*Accepted file types: jpg, pdf, doc, docx, txt, Max. file size: 100 MB.Parking for those with mobility limitations are most frequently accommodated in the North Front Street Garage at the Area 2 regional campus parking rate. If you believe that such an accommodation would be insufficient to meet your specific needs, please contact Parking Services by phone call to (860) 486-4930 or email message sent to parkingservices@uconn.edu.Parking for those with mobility limitations are most frequently accommodated in the TARGET Garage at the Area 2 regional campus parking rate. If you believe that such an accommodation would be insufficient to meet your specific needs, please contact Parking Services by phone call to (860) 486-4930 or email message sent to parkingservices@uconn.edu. Permit parking fee information is published on the Parking Services website.Payroll Deduction Authorization...*Payroll deductions for University parking permits will be made on a pre-tax basis, pursuant to the University's Pre-Tax Parking Plan. Additional information on the Pre-Tax Parking Plan is located on the Payroll website. Employees who wish to have payroll deductions for University parking permits made on an after-tax basis must elect to opt out of the Pre-Tax Parking Plan via the following link: pre-tax-parking. I AUTHORIZE the deduction of parking permit fees from my bi-weekly pay in accordance with the amounts established by Parking Services. I DO NOT authorize the deduction of parking permit fees from my bi-weekly pay. I will make alternative payment arrangements with Parking Services. Change Payroll Deduction Authorization...*Payroll deductions for University parking permits will be made on a pre-tax basis, pursuant to the University's Pre-Tax Parking Plan. No action is required for employees who do not wish to make changes to their current Plan election. Meaning, if you currently purchase a University parking permit via payroll deductions on a pre-tax basis, future deductions will continue to occur on a pre-tax basis, based on the permit fees established by Parking Services. If you currently purchase a University parking permit via payroll deductions on an after-tax basis, future deductions will continue to occur on an after-tax basis, based on the permit fees established by Parking Services. If you would like to change your parking deduction tax designation , you may do so at any time via the following link: pre-tax-parking. I AUTHORIZE a change to the deduction of parking permit fees from my bi-weekly pay based on the new permit type selected in accordance with the amounts established by Parking Services. I DO NOT authorize a change to the deduction of parking permit fees from my bi-weekly pay based on the new permit type selected. I will make alternative payment arrangements with Parking Services. Method of Payment - Credit CardReoccurring payments must be initiated by the credit-card holder in the Parking Services office, which is located on the Storrs campus. Credit/Debit Card - Single Payment of full permit price Credit/Debit Card - Reoccurring Monthly Payments (see fee schedule above for amounts) Method of Payment - Payroll Deduction*Permit fees will be paid by payroll deduction through the affiliate's employer. Payroll Deduction by Employer Billing Name or KFS Account Contact*Contact person for billing or KFS account authorization confirmation. First Last Method of Payment: KFS Account NumberBilling Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cash, Check and Money Order payments are accepted at the Parking Services office in Storrs. Check and Money Order payments may also be mailed to University of Connecticut, Parking Services, 3 Discovery Drive, Storrs, CT 06269-6199.Barnes and Noble College employees who choose to pay for their parking permits with credit/debit cards must come to the Parking Services office located at 3 Discovery Drive, Storrs to swipe their cards and thereby initiate payment(s). Please remember to bring your Credit/Debit card with you. Once reoccurring monthly credit card payments are initiated they will continue until the full purchase price of the permit is paid. There will be no need to return to the Parking Services office. Reoccurring credit/debit card payments are processed on the first day of every month. Notify Parking Services immediately if the credit/debit card used to secure the parking fee payments becomes invalid. Permits for which payment balances exist and their reoccurring credit/debit card payment is unavailable, will be immediately expired. Credit/Debit Card Payment Authorization* Yes, I authorize the one-time credit card payment of the parking permit fees as specified within the schedule above. Credit/Debit Card Payment Authorization* Yes, I authorize the monthly reccurring credit card payments of of the parking permit fees specified above. Name on Credit/Debit Card (if different from above) First Last Credit Card Billing Address Same as Home Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Acknowledgement of Parking Rules and Responsibilities*Applications are typically processed within five business days but that processing time be longer during high-volume periods. Those paying by credit or debit card will be contacted at the telephone number provided in order to obtain the account information needed to process the transaction. After the application is processed, the parking permit will be mailed to the address provided via the U.S. Postal Service. All outstanding parking fine balances must be fully paid by the applicant before a parking permit can be issued. With my signature I acknowledge that I have read and understand the Parking Rules and Regulation published on the University’s Parking Services website; the vehicles associated with my UConn parking permit may be ticketed, towed or immobilized when parked in violation of those rules and regulations. Yes, I acknowledge my understanding of the University's Parking Rules and Regulations and my intention to abide by them. Vehicle InformationSelect the vehicle types you would like to add (or change)...* Automobile Motorcycle Automobile InformationAutomobile License Plate Number* Automobile State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAutomobile Year*20212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Automobile Make*ACURAALFA ROMEOAMERICAN MOTORS CORPAPRILIAASTON MARTINAUDIAUSTINBABETHBAJABATAVUSBENELLIBENTLEYBERTONEBMWBRUMANABUICKCADILLACCHEVROLETCHRYSLERCOOPERCURRENT MOTOR CO.DAEWOODATSUNDEBLASIDERBIDIAHATSUDODGEDUCATIEAGLEFERRARIFIATFORDGARELIGAZELGENUINE SCOOTERGENUNGEOGENERAL MOTORS CORPGRUMMANHONDAHARLEY DAVIDSONHUMMERHUSQVARNAHYOSUNG MOTORSHYUNDAIINFINITIISUZUJAGUARJAWA MOTORSJEEPJIANJONWAYKASEAKAWASAKIKIAKYMCOLAMBRETTALAND ROVERLEXUSLINCOLNLOTUSMALAGUTIMARERATIMAZDAMBKMEBEAMEGOMERCURYMGMINARELLIMINIMITSUBISHIMONARKMOPEDS INDIAMOTOBECANEMOTOGUZZIMERCEDESMERKURNISSANNORMAN CYCLESNSUOLDSMOBILEOPELOTHER VEHICLEPEUGEOTPHILLIPS CYCLEPIAGGIOPLYMOUTHPOILINIPONTIACPORSCHEPROPHETEPUCHREIJURENAULTRIGAROLLS ROYCELAND / RANGE ROVERSAABSATURNSCIONSMART CARSOLESSTERLINGSUBARUSUZUKISYMTAOTAOTEMPTOMOSTOYOTATRIUMPHTUNTURIVESPAVICTORYVOLVOVOLKSWAGENYAMAHAYUGOZANELLAZF SHACHSZNENZUNDAPPModel* Automobile Color* Motorcycle InformationMotorcycle License Plate Number* Motorcycle State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificMotorcycle Year*201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Motorcycle Make*ACURAALFA ROMEOAMERICAN MOTORS CORPAPRILIAASTON MARTINAUDIAUSTINBABETHBAJABATAVUSBENELLIBENTLEYBERTONEBMWBRUMANABUICKCADILLACCHEVROLETCHRYSLERCOOPERCURRENT MOTOR CO.DAEWOODATSUNDEBLASIDERBIDIAHATSUDODGEDUCATIEAGLEFERRARIFIATFORDGARELIGAZELGENUINE SCOOTERGENUNGEOGENERAL MOTORS CORPGRUMMANHONDAHARLEY DAVIDSONHUMMERHUSQVARNAHYOSUNG MOTORSHYUNDAIINFINITIISUZUJAGUARJAWA MOTORSJEEPJIANJONWAYKASEAKAWASAKIKIAKYMCOLAMBRETTALAND ROVERLEXUSLINCOLNLOTUSMALAGUTIMARERATIMAZDAMBKMEBEAMEGOMERCURYMGMINARELLIMINIMITSUBISHIMONARKMOPEDS INDIAMOTOBECANEMOTOGUZZIMERCEDESMERKURNISSANNORMAN CYCLESNSUOLDSMOBILEOPELOTHER VEHICLEPEUGEOTPHILLIPS CYCLEPIAGGIOPLYMOUTHPOILINIPONTIACPORSCHEPROPHETEPUCHREIJURENAULTRIGAROLLS ROYCELAND / RANGE ROVERSAABSATURNSCIONSMART CARSOLESSTERLINGSUBARUSUZUKISYMTAOTAOTEMPTOMOSTOYOTATRIUMPHTUNTURIVESPAVICTORYVOLVOVOLKSWAGENYAMAHAYUGOZANELLAZF SHACHSZNENZUNDAPPMotorcycle Color* PhoneThis field is for validation purposes and should be left unchanged.