Danielle House

Danielle House, Binghamton,NY Vehicle Donation Quotation Form
 

In the spirit of helping others in need, The Danielle House offers a temporary, safe and homelike atmosphere for patients' families and loved ones, and for outpatients seeking respite during a medical crisis, during treatment phases of medical care, or medical related services. Our goal is to provide love, support, comfort, and affordable accommodations for those who find themselves in the Triple Cities area in need of a place to stay.

Vehicle Donation Quotation Form

Please note: By filling out the form below you are not committed to donating your car. Filling out this form will allow us to contact you with a quote on the price the charity of your choice will receive for your vehicle. All personal data is kept strictly private and will never be sold.
 
Owner Information Section
Name * State/Province *
Address on Ownership * ZIP/Postal Code *
City *
Daytime Phone Number * Phone/Cell/Work Number *
Email *

Donating Your vehicle?

Yes, I want to donate my vehicle to Danielle House.

Vehicle Information Section

Year * Make *
Model * Mileage
Licence Plate VIN #
 If your vehicle is located at a different address from your home address, please check the box and then complete the following section, if same as home address (skip)
Condition of vehicle Comments about vehicle
*
I do have the ownership / title to transfer to the Authorized Treatment Facility.

Vehicle Images Section
Uploading images will help us to better determine the value of your vehicle, possibly increasing what we will pay for your car.

Human? Answer this question 4+7=