Vehicle Contribution Form
Please fill out this form if you are interested or desire to donate your vehicle to Midsouth Hope Garage. We are a registered 501c3 and all donations are tax deductible for their value. We are happy to answer questions at midsouthhopegarage@gmail.com. Thank you!
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Date
*
-
Month
-
Day
Year
Date
Are you the Title Holder?
*
Yes
No
Contributor on Title
*
First Name
Last Name
Address of Contributor on Title
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Vehicle Year, Make, Model
*
Vehicle Color
*
Vehicle VIN
*
Vehicle Mileage
*
Features That Impact Value
Vehicle Body Condition
*
Good
Bad
Fair
Engine Condition
*
Good
Bad
Fair
Tires Need Replacing?
*
Yes
No
Other
Kelley Blue Book Value (Good and Fair Market Value)
If possible, please provide a photo (Front and Rear View) of vehicle
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