Triad Family Services - Vehicle Donation

Take part in a great cause by donating a vehicle to the Triad Family Services Car Donation Program. Please complete the form below and a representative will contact you within four business days.

You may also download the Adobe PDF version and fax a copy to "Car Program" at 916-631-1328.

Vehicle Donation Form

Date:
Donor Name:		SSN: XXX-XX-XXXX
Mailing Address:
City:		State:
Zip Code:
Phone Number:		Alternate Phone:
Vehicle Location:
City:		State:
Zip Code:

Vehicle Information

Year:		Make:
Model:		VIN#
License Number:
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:
Please take a moment to verify that the information you have entered is correct. All information is confidential. Triad Family Services does not sell or share any personal information about you with others.

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© 2006 Triad Family Services Current Visitors: 21	Last Update: 4/30/2007