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Vehicle Donation Form



You may use this easy online form to donate your car, truck, boat, trailer or RV. If you have any questions, please view our FAQs; e-mail us at donateacar@alz.org; or call the Donate-a-Car processing center toll free, seven days a week at
1-800-240-0160.

DONOR INFORMATION

* First Name:

* Last Name:

* Email:

* Address:

* City

* State

* ZIP

* Phone Number:



VEHICLE LOCATION

Vehicle at same address?  Yes  

Vehicle Address

Vehicle City

Vehicle State

Vehicle ZIP



VEHICLE INFORMATION

Yehicle Year

Vehicle Make

Vehicle Model

License Plate #

VIN



Damage to body (describe):

Damage to interior (describe):

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

Do you have the certificate of title? If not, please explain:

Special instructions or other comments: