12. Theft or damage to Beryl Bikes Use this form to report non-emergency damage or destruction of Beryl bikes used as part of Norwich's bike scheme. Full name * Contact number * Email * Date of birth * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year191119121913191419151916191719181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021 Was the bike damaged or stolen? * Stolen Damaged Date of incident * Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year201620172018201920202021 Location of incident * Did you witness an incident in person? * Yes No Did anyone else witness the incident in person? * Yes No Is the suspect know? * Yes No Do you have confirmed CCTV footage of the incident? * Yes No Please provide a brief outline of the incident
