Vehicle Donation Form (2 of 3)

Tell Us About Your Donation

Vehicle Type*

Year*

Make*

Model*

Miles*

ID# (VIN)

Plate/State of Registration

Is the Vehicle on the Road and Running?*

Is there a lien on the title?*

Do you have the title paperwork?*

Is the Registration Current?*

Do you have the keys?*

Are the tires inflated?*

Is the Vehicle Intact?*

Please describe any mechanical problems or damage
to the vehicle (interior or exterior)

Check all that apply:
 Junker 
 Old But Decent 
 Moderate Condition 
 Pretty New 
 Good Condition 
 Great Condition 
 Needs Body Work 
 Needs Mechanical Work 
 Does Not Run 
 Is a Pickup Truck 
 Is a Box Truck 
 Is a Gas Guzzler 
 Is Fuel Efficient 
 Just Needs a New Home 
Vehicle Location*

View the progress on the Clayes House restoration