Autos for Animals Donation Form

Page 1 of 2

Your Info

First Name

Middle Name/Initial

Leave Blank if N/A

Last Name

Email Address

Phone Number

Preferred Phone

Mailing Street Address (Include Apartment/Suite Number)

City

State

Zip/Postal Code

Mailing Country

Tax Information

SSN/EIN

If your vehicle sells for over $500 and you wish to claim the donation on your taxes, the Oregon Humane Society must file a form which requires your tax ID (SSN or EIN). If you don't want to claim this donation, please leave this field blank.

How did you hear about us?

Is the vehicle location the same as your address listed above?

YesNo

Vehicle Location

Vehicle Street Address (Include Apartment/Suite Number)

City

State

Zip/Postal Code

Page 2 - Vehicle Info

Year

Make

Model

Color

License Plate Number

Vehicle Identification Number (VIN)

You can find your vehicle's VIN on your driver's side door jam or in the vehicle title.

Mileage

Do you have the vehicle title?

YesNo

Title State

Condition

Is the vehicle running?

YesNo

Describe the vehicle's mechanical condition

Describe the vehicle's interior and exterior condition

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