VEHICLE DONATION FORM
A towing service will call the donor within four business days to schedule an appointment.
Donor Information
First Name*     Last Name*
Address*
City*     State*     Zip*
Daytime Phone*     Alternative Phone
Email*
Vehicle Location
Address (car's location)
City     State     Zip
Vehicle Information
Year     Make     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.
Mileage, Special Instructions or Other Comments:
If your vehicle has low mileage or has any value not described above, please tell us about it in the
above comments box.
* denotes required
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Safe Haven Animal SanctuarySM
Mailing: PO Box 9005
San Jose, CA 95157
Telephone: (408) 420-SAFE (7233)
Fax: (866) 833-2451 (toll free)
E-mail: info@safehavenanimalsanctuary.org
 Please report any technical issues to:
webmaster@safehavenanimalsanctuary.org

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