Name *

First Name

Last Name

Type of Donation?

Car

Boat

RV

Property

Other

Does the vehicle start and drive?

Yes

No

Please check if the vehicle has any of the following

Is the check engine light on?

Missing parts inside or outside the car?

Glass or plastic on the windshield or lights cracked?

Any body damage larger than a baseball?

Is this address the same as the one you would like the final sales receipt for tax purposes sent?

Yes

No