LTSC's Vehicle Donation Form
DONOR INFORMATION
Current owner of vehicle
First Name
Your answer
Last Name
Your answer
Address, City, State, Zip
Your answer
Phone Number *
Your answer
Email Address *
Your answer
CONTACT PERSON
If different from Donor
Contact First Name
Your answer
Contact Last Name
Your answer
Contact Phone Number
Your answer
VEHICLE INFORMATION
Enter any information known
Year
Your answer
Make
Your answer
Model
Your answer
License Plate
Your answer
VIN
Your answer
Condition of Vehicle
Do you have the title?
Location of Vehicle
If different from above
Your answer
Additional Notes
Your answer
How did you hear about LTSC's vehicle donation program?
Check all that apply
Other
Your answer
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This form was created inside of Little Tokyo Service Center.