Vehicle Donation Form

Please complete the form below and press "Submit." A Tommy Nobis Foundation staff member will contact you shortly.

Proceeds from the sale of your vehicle support vocational and employment services for individuals with disabilities or other barriers to employment. For your generosity, you will receive an income tax deduction - and the assurance that you have made a difference in the lives of many.

Email (*)
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Submitter's Name
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Donor's Name as it appears on car title
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Last Name (*)
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First Name (*)
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Last Name
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First Name
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Company Name
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Address
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Address 2
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City
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State
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Zipcode
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Home Phone
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Work Phone
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Alternate Phone
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Vehicle Location
Is the vehicle at the above address?
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If no, indicate location
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Current Address
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City
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State
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Zipcode
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Contact Person
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Contact Phone
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Vehicle Information
Year
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Make
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Model
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VIN
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Number of Doors
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Color
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Mileage
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Does the vehicle run?
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To maximize the value from the sale of your vehicle, please describe:
Interior Condition
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Exterior Condition
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Mechanical Condition
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Do you have keys?
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How would you rate the tires?
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Are the tires inflated?
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Does the vehicle have a battery?
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Is the vehicle accessible to tow truck and not parked in a garage?
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Title Number
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Title State
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Title Control Number
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Is there or has there ever been a lien on the vehicle?
Invalid Input		 On the front of the title, if there is a financial institution listed, you will be required to have a lien release
When your vehicle is picked up by our towing company, where would you like us to leave the receipt?
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Have you ever heard of the Tommy Nobis Center?
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How were you referred to the Tommy Nobis Center?
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Additional Comments
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