Automobile Donation Form

Your gift of an automobile can help to change lives in our community!

Please use the following form to donate your car, boat or RV. We work with Car Program, LLC to process your donation. City Mission receives 70% of the net proceeds to benefit those in need.

The towing company and customer service department will contact you via telephone within a few days to arrange pickup of your vehicle. For more details, check out our Automobile Donation FAQs.

Donor Info:

Date

Name

Address

City

State/Province

Zip/Postal Code

Phone

Alternate Phone

Email Address

Automobile Info:

Year

Make

Model

Mileage

License #

VIN#

Please check all that apply:
2-door
4-door
Station Wagon
4 Wheel Drive

Does vehicle drive/run as is? Explain:

Do you have title? Explain.

Describe any damage (Engine, transmission, body, tires, etc.)

Special Instructions

Vehicle Location (If different from above.)