Donate a Boat to Charity Owner Information

Name (First and Last):

Street Address:

City:

State:

Zip:

Cell phone:

Daytime Phone:

Email address:

(This is required)

Donate a Boat to Charity Boat Information (Be as specific as possible)

Boat Make:

Model Description:

Boat Year:

Hours in service:

Length and Width of boat:

The name of the boat:

HIN (Hull Identification Number):

Do you have the Certificate of Title?
Please write how the name(s) appear on the TITLE:

State Registration Number:

Condition of hull including any damage:

Condition of interior including any damage:

HP of Engine(s):

Type of engine:
(If NONE, please select that).

Condition of engine(s)?
Please fully describe the engine including whether working and any other details:

Is the boat seaworthy?
(Provide details if needed)

Donate a Boat to Charity Trailer Information

Condition of trailer:
Please describe the trailer and its current condition:

Will the trailer safely transport the boat?

Do you have the Certificate of Title?
Please write how the name(s) appear on the TITLE:

Registered? Current?

VIN (Vehicle Identification Number):

License plate number:

Location and Special Instructions

Location of boat (address, city, state & zip):

Phone number & name of any contact person.
NOTE: If boat at marina, name & number of contact person at marina:

Tax Receipt or Recycling Benefit

***Tax Receipt or Coupons/Vacations/Cruise:

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Thank you for your participation in our program.

We will process your form and then you will be contacted very soon by email.

Please stay alert for email responses. If for some reason we are not able to pick up in your state we will let you know.