TRUCKS, RV's, VANS, MOTORCYCLES and

CONSTRUCTION /

INDUSTRIAL EQUIPMENT

DONATION FORM

A NON-PROFIT CHARITY 501(C)3
 
Please use this form to make a donation.  If you have any questions you would like answered previous to initiating the donation process, please feel free to email or call 631-470-1198 (Monday thru Friday 9am - 5pm est).
* Required
Name:*
Address:*
City:*
State:*
Zip:*
Phone:*
Best  Time To Call:*
Email:*
Vehicle Information:
Year:*
Make:*
Model:*
Vehicle Type:*
Mileage:*
License Plate #:
Plate State:*
Color:
Exterior Condition:*
Interior Condition:*
Running:*
Have Keys:*
How Long Sitting:*
Tires Inflated:*
Vehicle Intact:*
Is your vehicle registered as a non-operated vehicle?
Do you know what mechanical problems this vehicle has?  Please explain, if any  (engine, transmission, brakes, clutch, differential, tires, etc...)
Do you know what body damage this vehicle has?  Please explain, if any  (paint, rust, dents, corrosion, etc...)
Does the interior have any damage?   Please explain, if any  (seats, dashboard, carpet, door panels, headliner, etc...)
Title:*
VIN:*
Is Title in Donor's Name:*
Is Registration Current:*
Any Comments You Would Like To Give Us?