Long Hill Fire District Vehicle Donation Form
Please complete this form when donating a vehicle. You will need to provide a title free of liens (if under 20 years old) and remove all personal belongings.
Donor Name
*
First Name
Last Name
Address (where the receipt of donation letter should be mailed)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
VIN Number
*
Year
*
Make
*
Model
*
Color
License Plate Removed?
*
Yes
No
Does the vehicle run?
*
Yes
No
Do you have the title?
*
Yes
No
Donor Signature
*
Continue
Continue
Should be Empty: