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DONATION FORM I, (donor name) _____________________________________________________ of (donor address) ___________________________________________________ offer my (year, make and model of vehicle) ______________________________ the VIN number is __________________________________________________ and the odometer reading is ___________________________________________ I am offering my vehicle to Junk My Car Now Ltd. at no cost for the purposes of auctioning or recycling my vehicle to generate a donation to the charity as listed: _________________________________________________________________ Charity Name I, the donor, have clear and lawful title of the vehicle being provided for charitable purpose and desire Junk My Car Now Ltd. to facilitate a donation on my behalf, in accordance with the following understanding. I understand that Junk My Car Now Ltd. will make a maximum donation of $125 in the event of recycling the vehicle, and will provide the charity with up to 80% of the net sale after deducting $250 from the gross sale of the vehicle. Junk My Car Now Ltd. will submit the donation proceeds to the charity on behalf of the donor, in the name of the donor, and request the charity provide a legally endorsed tax receipt to the donor. Donor Name: ____________________________________ Printed Donor Name: ____________________________________ Signature Date of Donation: ___________________________________ To be handed to tow truck driver at point of pick up with Registration Certificate.
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