Donate a vehicle!
Donor Information
Full Name
*
First Name
Last Name
If you are donating on behalf of a company, please include the name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
Vehicle Details
Vehicle Type
*
VIN
*
Year
*
Make
*
example@example.com
Model
*
Current Mileage
*
ex: 89,000
Is the vehicle currently registered and insured?
*
Yes
No
Is the vehicle in running condition? Any known issues or damage?
*
Upload a photo of vehicle
Browse Files
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Choose a file
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of
Ownership
Name on Title
*
State of Title
*
Is there a lien, loan, or claim against the vehicle?
*
Please Select
Yes
No
Logistics
Is the vehicle at your address provided above?
*
Yes
No
Will you be able to deliver the vehicle, or will it need to be picked up/towed?
*
Please Select
Deliver
Pick up
Tow
Do you have the license plates removed (if required by your state)?
*
Please Select
Yes
No
Acknowledgement / Donation
By checking the boxes and signing below, I confirm:
*
I am the legal owner of this vehicle and no one else has legal claim or right to this vehicle
There are no liens, loans or claims against this vehicle
I understand and agree that the rescue may sell, auction, recycle or otherwise use the vehicle at its discretion
I confirm this donation is final and cannot be reversed
Signature
*
Do you need a donation receipt?
Yes
No
Continue
Continue
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