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Vehicle Donation Form

Thank you for your donation. 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.

            E-mail Address:  
 
  Submitter's Name:  
 
  Donor's Name(s) as it appears on the title:  
   
  Last Name: First Name:
 
Last Name: First Name:
  Company Name:  
 
  Current Address:  
 
  Cross Street:  
 
  City: State: Zip:
 
  
  Home Phone: Work Phone:
Cell Phone: Other Phone:
    
Is the vehicle located at the above address?
If not, indicate vehicle location
Location Name:
(i.e. private residence, Smith's Repair Shop, etc.)
Current Address:
City: State: Zip:
  
Contact Person: Contact Phone:
   
  Vehicle Information
     
  Year:
  Make:
  Model:
  VIN:
  # Doors:
  Color:
  Mileage:
  Does your vehicle run?
    
  To maximize the value from the sale of your vehicle, could you describe:
    Condition of Interior:
    Condition of Exterior:
    Mechanical Condition (please elaborate):
   
  Does your vehicle have keys?  
  How do you rate the tires?  
  Are the tires inflated?  
  Does your vehicle have a battery?  
  Is the vehicle accessible to tow truck and not parked in a garage?  
  Title Number:
  Title State:
  Title Control Number:
   
  Is there or has there ever been a lien on the vehicle?
  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? (Example: mailbox, under door, mail to me).
 
  Have you ever heard of the Tommy Nobis Center?  
  How were you referred to the Tommy Nobis Center?
   
  We welcome your comments in the space below:
 
   







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Vehicle Donation Form
 

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