If you are interested in donating a vehicle to the OUTREACH Car Donation Program, please print, fill out, and mail or fax the form below to:
OUTREACH
ATTN: Carol Hummel
926 Rock Ave Ste 10
San Jose, CA 95131
Donating your vehicle is easier than selling and you will receive a tax deduction for your charitable contribution. One call does it all!
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VEHICLE PICK-UP REQUEST |
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FROM: OUTREACH AND ESCORT, INC. 926 Rock Ave,
STE 10 DONOR INFORMATION: DATE: _____ / _____ / _____ NAME: ______________________________________________________________ HOME ADDRESS: _____________________________________________________ CITY : _______________________ STATE: ______________ ZIP: ______________ HOME PHONE: (____) ______________ ALTERNATIVE # (____) ______________ VEHICLE INFORMATION YEAR: __________________ MAKE: _________________ MODEL: ____________ TYPE: ___________________________ COLOR: ____________________________ LICENSE PLATE #: _____________________ STATE: ________________________ VIN #: _______________________________________________________________ VEHICLE PICK-UP LOCATION: _________________________________________ _____________________________________________________________________ Is the car running and is it safe to drive at least 50 miles? YES________ NO________ Will it require a tow truck? YES______ NO_______ VEHICLE CONDITION MECHANICAL PROBLEMS: _____________________________________________ ______________________________________________________________________ EXTERIOR DAMAGE: ___________________________________________________ INTERIOR DAMAGE: ___________________________________________________ SPECIAL PICK-UP INSTRUCTIONS: ______________________________________ ______________________________________________________________________
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San Jose, CA 95131 (408) 436-2865
FAX (408) 382-0470