Lost Dog and Cat Rescue Foundation
 Vehicle Donation Pick-Up Request

(Please complete this form and transmit to LDCRF)

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

Thank you for your Donation!

Donor Name         Date

Vehicle Location

City:       State   Zip 

Phone       Alternative #

E-Mail Address:      

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 problems/damage:

Engine
Trans.
Tires
Body
Other
None

Special Instructions:

STOP! Before you submit please print the completed donation form and save for your records!

Sponsored by:
Car Program  *  3755 Omec Circle Unit #4  *  Rancho Cordova  *  CA 95742
tel (800) 513-6560   fax (916) 631-4336  *  kirton@carprogram.com