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Secure On-Line Miscellaneous Property Donation Form!

* Required fields Reminder: If the item(s) you are donating requires a title
from the state, we can help you with getting it.

Donor Information:

*First Name:
*Last Name:
NOTE: If the donation is currently at some other location,
you will have the opportunity to specify it below.
*Mailing Address 1:
Mailing Address 2:
*City:
*State:
*Zip Code:
*Phone:
*eMail:
Do you plan on taking a tax deduction?  Yes No

Location of donation item, if different from mailing address:

Name of establishment:
Contact:
Phone number:
Address:
City:
State:
Zip code:

Donation Information:

    What is it?:
    General Condition:
Need a duplicate title? Yes No
    Other Comments
    about the donation:

General:

How did you hear about us?
Radio: (Station)
Newspaper
Billboard
Internet search
Personal referral (Who?)
Other publication (Which one?)


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