CA Narcotic Officers' Assoc.
Vehicle Donation Form
* Please complete and fax this form to Car Program 916-631-1328 or 916-631-4336.
* The donor will be contacted within four business days at the latest.
Date _______________________
Donor Name _________________________________________________________________
Phone # ___________________________ Alternative # _____________________________
Vehicle Location ______________________________________________________________
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 problems/damage:
Engine __________________________________________________________________
Trans. __________________________________________________________________
Tires __________________________________________________________________
Body __________________________________________________________________
Other __________________________________________________________________
None
Special Instructions: __________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Car Program LLC * 3755 Omec Circle Unit #4 * Rancho Cordova * CA 95742
tel (800) 513-6560 * fax (916) 631-4336 * info@carprogram.com