Boxer Angels Rescue
Vehicle Donation Form

* Please print, complete and fax this form to Car Program at 916-631-1328, 631-1307, or 631-4336
or if you do not have access to a fax machine, send to the address at the bottom, Attention: Cory.

* The donor will be contacted within four business days at the latest.

Donor Name _____________________________________ Date _______________________

Vehicle Location ______________________________________________________________

City _______________________________________ State _______ Zip _______________

Phone # ___________________________ Alternative # _____________________________

Mailing Address (If different than above) ____________________________________________

City _______________________________________ State _______ Zip _______________

Vehicle Information:

Year _ Make Model ____________________

License # _______________ VIN # _____________________________________________

Please check all that apply: 2-Door 4-Door Station-Wagon 4-Wheel-Drive

Does the vehicle run and drive as is? Yes No, explain____________________________

Do you have the Title? Yes No, explain_______________________________________

Please note any problems/damage:

Engine ______________________________________________________________________

Trans. ______________________________________________________________________

Tires ______________________________________________________________________

Body ______________________________________________________________________

Other ______________________________________________________________________

Special Instructions: __________________________________________________________