SOQUEL SPORTS FOUNDATION - Vehicle Donation Form
DONOR INFORMATION
Donor Name:
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Address:
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E-mail:
*
Daytime Phone:
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Alternate Phone:
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City:
*
State:
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AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip code:
*
Date:
VEHICLE INFORMATION
Is vehicle at above address?
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No
Yes
If no, please confirm location: (include address, city, state, etc):
Year of Vehicle
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Make / Model:
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License Plate #
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Vehichle Identification Number (VIN):
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Please check all that apply:
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2-Door
4-Door
4-Wheel Drive
Station Wagon
Does the vehicle run and drive as is?
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No
Yes
If No, explain:
Do you have the Title?
*
No
Yes
If No, explain:
Please note any problems/damage to: Engine, Transmission, Tires, Body, Other:
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Please re-type what is displayed here:
*