St. Vincent de Paul Northern Kentucky
Vehicle Donation Receipt
Name
First Name
Last Name
E-mail
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Vehicle Model
Back
Next
Vehicle Make
Vehicle Year
VIN #
Body Style
Please Select
2 Door
4 Door
Color
Odometer Reading
Vehicle Condition
If your vehicle is in good condition, would you be open to the vehicle being repurposed for a neighbor in need of a vehicle? We partner with Samaritan Car Care Clinic for repairs and repurposing when we can.
Yes
No
My vehicle is not in good enough condition
What state is your vehicle titled in?
Clear title? (vehicle should not have any liens or tax owed)
Location of Keys
Please provide vehicle plate #
Are the plates on the vehicle
Please Select
Yes
No
Location of Vehicle
Please Select
Vehicle not driveable (SVdP to pick up)
Vehicle will be dropped off at Erlanger Location
Special instructions or comments:
How did you hear about our Vehicle Donation program?
Submit Form
Should be Empty: