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Vehicle Donation Contract
Contact Information
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(mm/dd/yyyy)
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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Vehicle Information
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Please check all that apply
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This field is optional. If you prefer to give your TIN securely, please call 937.294.6505 ext 13 after completing this form.
Thank you!

Please note, the IRS requires form 1098c to be completed in order to claim a tax deduction for vehicle contributions greater than $500.