Car Donation

Car Donation
Car Donation Appointment*

Contact Information
Name*
Email*
Home Address*
City*
State*
Zip Code*
Social Security Number (SSN)
Providing your SSN allows us to submit a 1098-C form if your car sells for more than $500.
Phone Number
How did you hear about us? *
More details...
Please provide more details if you heard about NLB through your church, a personal connection, or Other.

Vehicle Information
Year*
Make*
Model*
Mileage
Vehicle Identification Number (VIN)
Do you have the title?*

YesNo
What repairs does the vehicle need?
Is the Vehicle Location the same as the Home Address?*

YesNo
Vehicle Location*
City*
State*
Zip Code*

We apologize for the inconvenience.

Unfortunately, we are unable to schedule your donation online without your title. Please give us a call at 678-679-1171 to discuss how we can proceed with your donation.

Thank you.

Please review your information and hit the submit button at the bottom of the next page.
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