LIFT3 Support Group

LIFT3 Vehicle/Vessel Donation Form You may use this Easy Online Donation Form to donate your car, truck, boat, trailer or RV. If you have any questions you would like answered previous to initiating the donation process, please feel free to email LIFT3 or call us at (707)398-6865). Donor Information: First Name: Last Name: Address: City: State: Zip Code: Daytime Phone: Evening Phone: eMail Address:

What Type of Vehicle/Vessel Are You Donating?

Car Truck Van Trailer Boat Other

If you selected “Other” please describe what you are donating in the space below.

Other:

Vehicle Location:

Address: City: State: Zip Code:

Vehicle Information:

Year: Make: Model:

License Plate: VIN:

Damage to Body (Describe):

Damage to Interior (Describe):

Is your vehicle drivable as is? If not, please explain below:

Yes:
No:

Do you have the Certificate of Title? If not, please explain below.

Yes:
No:

Mileage:

Current Vehicle Mileage:

Special Instructions or Other Comments:

If your vehicle has any value not described above, please tell us about it in the above Comments box.