Goodwill Industries


Automobile Donation Pickup Form Please provide the following information. Goodwill will contact you to verify a pickup date.
Contact Information
First Name	*
Middle Initial
Last Name	*
Prefix
Address Line 1	*
Address Line 2
Zip Code	*
Daytime Phone	*
Evening Phone
E-mail Address
Automobile Pick Up Information Click here to use the same address as above
Address	*
Address
Zip Code	*
Do you plan to claim a tax deduction for this vehicle donation?	Yes No
What is your taxpayer ID (Social Security Number)?	*
Do you have the title for the vehicle?	Yes No
Do you have the key(s) for the vehicle?	Yes No
Is the vehicle drivable?	Yes No
Desired date for vehicle pick up	*
Vehicle: Make * Model * Year *
Vehicle Identification Number
Notes
* = Required Field

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Automobile Donation Pickup Form