DONATING YOUR VEHICLE IS FAST, FREE & EASY!

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Melina Preston
6 years ago
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1 The National Kidney Foundation of Arizona (NKF AZ) is delighted that you are interested in the Kidney Keys Donation Program! The Kidney Keys Donation Program is the single greatest source of funding for our patient programs. Your donation is critical. It allows NKFAZ to provide life-saving medications and emergency living expenses to Arizona s children and adults with kidney failure who have no other resources. Twenty million people one in nine American adults have chronic kidney disease, and millions more are at an increased risk. Sadly, most do not know they are ill. With so many people to help, we need your support now more than ever before. When you choose the National Kidney Foundation of Arizona, your donation will go the distance! Because less than 10% of our budget is used for administrative costs, nearly all of the funds raised from your vehicle donation will go directly to those who need it most the patients. DONATING YOUR VEHICLE IS FAST, FREE & EASY! Donating your vehicle to NKF AZ is truly fast, free and easy. There are just a few quick things that will ensure that your donation and title transfer progress as smoothly and quickly as possible. 1) Please mail or bring the following to the NKFAZ office: Title: Transfer of an Arizona title requires that the name and signature on the back must match exactly the typed name on the front. The signature must be notarized at the time of signing. If you choose to bring your title to our office, a notary public is usually available during normal business hours. Please call first to verify that a notary will be in the office. If your vehicle is titled in another state, be sure to read the title instructions carefully as requirements vary by state. Notarized Limited Power of Attorney: This document enables the NKF AZ to expedite the title transfer of your vehicle. Please call our office if you have any questions about who should sign this document. Odometer Disclosure Statement: This document is important for all title transfers. Original Lien Release: Only required if a lien holder is showing on the title and the lien date is 12 years old or less. MVD requires this original document even if the lien has been paid. 2) After mailing or delivering your Car Donation Packet: Our towing company representative will contact you to schedule a convenient pick up time. NKF AZ must receive your completed paperwork before a tow can be scheduled. You will receive an IRS approved receipt by mail after the vehicle is sold.

2 YOU MIGHT BE WONDERING 1. How can I speed up the donation and title transfer? Be sure to completely fill out and mail/bring in all of the required documents. Without a properly executed title, NKFAZ cannot process and transfer your title. 2. What if there is more than one person on the title? The title must be signed by all responsible parties, so if Jane Doe AND John Doe are on the title, then both signatures are required Jane Doe AND/OR John Doe are on the title, then both signatures are required Jane Doe OR John Doe are on the title, then either signature is fine 3. Is my donation tax deductible? NKFAZ is a 501 (c) (3) non-profit organization, so donating your vehicle qualifies as a charitable contribution and may be tax deductible, depending on whether or not you itemize deductions on your tax return. The receipt for your donation will be mailed after the vehicle is sold. In order to comply with the American Jobs Creation Act of 2004, we may be required to put your identification number on the receipt. If you did not provide that information to us previously, we may be contacting you prior to sending the receipt. Please consult your tax advisor or the IRS if you have any questions regarding your donation. Additionally, you can consult the IRS if you have questions regarding charitable donations of noncash gifts. 4. When will my vehicle be picked up? A towing company representative will contact you to schedule a convenient pick up time. (The towing company needs safe access to your vehicle.) Remember, NKF AZ must receive all paperwork before a tow can be scheduled. Please remember to remove all personal belongings from the vehicle. 5. What do I do with the license plate? Once we schedule your vehicle to be towed, remove your license plate from the vehicle. The license plate will remain with you. 6. How does my donation help? Your donation will provide the National Kidney Foundation of Arizona with funds to help Arizona s children and adults with kidney failure who have NO OTHER RESOURCES. NKF AZ is the only statewide agency providing crisis intervention to Arizona s dialysis patients and transplant recipients and their families.

3 ODOMETER DISCLOSURE STATEMENT Today s Date I, (Donor s Name), state the odometer (of the vehicle described below) now reads (no decimals) miles and to the best of my knowledge reflects the actual mileage of the vehicle described below, unless one of the following statements is checked: Please check any that apply: (1) I hereby certify that to the best of my knowledge the odometer reading reflects the amount of mileage in excess of its mechanical limits. (2) I hereby certify that the odometer reading is NOT the actual mileage. Please fill out the following information to the best of your ability: Year Make Model Body Style Vehicle Identification # Donor s Printed Name Donor s Signature Street Address City State Zip Phone Number (Home) (Work) (Cell) For Office Use Only: Transferee s Name: National Kidney Foundation of Arizona Transferee s Signature:_

LIMITED POWER OF ATTORNEY I,, of the County of, State of_, Owner of motor vehicle: Year: Make: Model: Body Style: VIN Number: by this instrument constitute and appoint the National Kidney Foundation

4 LIMITED POWER OF ATTORNEY I,, of the County of, State of_, Owner of motor vehicle: Year: Make: Model: Body Style: VIN Number: by this instrument constitute and appoint the National Kidney Foundation of Arizona, 360 East Coronado Road, Suite # 180, Phoenix, Arizona 85004, my true and lawful attorney, for me and in my name to assign to said motor vehicle an NKFAZ and/or to execute all necessary written instruments in connection therewith and to whomsoever as may be designated by my said attorney. Executed on this day of, 20. Signed: Driver s License number: Date of Birth: Signed and sworn to before me this day of, 20. Notary Public County and State

5 IDENTIFICATION NUMBER DISCLOSURE STATEMENT Today s Date In cases where the donated vehicle sells for greater than $500, Internal Revenue Service Section 170(f)(12) requires the Donor s identification number (an individual s Social Security number or an organization s Employee Identification number) if the donor would like to claim a deduction of more than $500. The National Kidney Foundation of Arizona does not require this information to complete donation paperwork and does not offer tax advice. If you have any questions regarding this form, please contact your tax representative. Donor s Name Donor s Identification Number Donor s Signature

6 Dear Donor, Thank you for choosing to donate your vehicle to the National Kidney Foundation of Arizona! We understand that every vehicle means a lot to its owner and every vehicle has a story. If you have a funny, meaningful or interesting story that you would like to share, or if you would like to tell us why you decided to donate to the National Kidney Foundation of Arizona, we would love to hear it! We thank you for taking the time to share your story with us! The National Kidney Foundation of Arizona You may also enclose a picture of your vehicle should you have one!

Car Donation Information Sheet Name of Donor: Contact Number: How Did You Hear About Us? Year / Make / Model Color of the Vehicle Approximate Mileage Is the vehicle drivable? When was it driven last?

7 Car Donation Information Sheet Name of Donor: Contact Number: How Did You Hear About Us? Year / Make / Model Color of the Vehicle Approximate Mileage Is the vehicle drivable? When was it driven last? Condition of the Car: Body in Good Condition? Interior in Good Condition? Air Conditioning Works? Radio Works? Windows in Good Condition? Tires Have Air? Address of the vehicle (incl. Cross Streets): Mailing Address for Paperwork:

Staab Agency. Thank you for inquiring about our registration service.

Staab Agency. Thank you for inquiring about our registration service. Staab Agency Shirley St. Pierre / Statutory Agent P. O. Box 942 / 259 Goose Hill Road Jefferson, Me 04348 Tel: 800-648-8805 / (207)-549-7541 Fax: (207)-549-7638 Thank you for inquiring about our registration