List Your Vehicle

Please note there is no fee to submit this application.

You will need the following documents:

Copy of Government issued photo ID
Copy of vehicle title
Documentation showing vehicle operation over the past year.
Clear Photo of Vehicle

Registered Owner Owner (if applicable) Mailing Address *

Last Name *

First Name *

Business Name

Additional Contact (Optional- if different from above) *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone *

Odometer Reading (Mileage) *

Vehicle Identification Number (VIN) *

Vehicle Model Year: Vehicle Make *

Retirement Vehicle Information

Vehicle License Plate *

Vehicle Model & Number of Cylinders *

Miles Per Gallon (City) *

Desired Donation Amount *

Why do you need to get funded to scrap your car *

Consumer Representations and Disclosures:

The vehicle described above is the vehicle to be retired and: Is currently registered as an operational vehicle for the last year. I will provide documentation demonstrating that I have owned the vehicle for at least one year prior to the date of application submittal. Is a gasoline or diesel powered light or medium vehicle. I understand that I must retire my vehicle by transferring title to an authorized dismantler and provide proof of ownership and photo identification. In addition to the requirements listed above, I understand that additional requirements may apply. Under penalty of perjury, I certify that: I am the owner of the vehicle and the title is free and clear of all leans. My signature below gives express written consent to the company and/or its agents or designees to capture, use, study, report, and disclose information provided in this application and any related vehicle emissions data to other third parties as allowable under applicable federal, state, and/or local laws or regulations. By submission of this document, I declare, under penalty of perjury, the information provided within this Application is true and correct.

File Upload *

Click or drag files to this area to upload. You can upload up to 6 files.

You will need to provide the following documents: Copy of Government issued photo ID, Copy of vehicle title, Documentation showing vehicle operation over the past year. (Current Registration), Clear Photo of Vehicle

*Digital Signature *

Terms *

I Agree that by typing my name above, that this will act as my digital signature

Eligibility Criteria

Vehicle must be10 years or older
Must get 15 or less MPG
Have title clear of any leans
Must have owned vehicle and had it registered for at least 1 year
Must show proof of insurance for last year
Vehicle must have 3 remaining years of useful life
Equipment requirements:
Vehicle must start using keyed ignition system
Vehicle shall be driven forward and in reverse for 25 feet under its own power
All doors are present and in place
The hood is in place
The dashboard is in place
The windshield is in place
The driver’s seat is in place
Interior pedals controlling the brake, clutch, and accelerator, are operational
One bumper and all side and/or quarter panels are present and in place
Vehicle drivability is not affected by any body, steering, or suspension damage
Exhaust system is present and in place
One headlight, one taillight, and one brake light are present and in place
One side window glass is present and in place
No starting fluid aids- no gasoline down the carburetor to start the vehicle
Cannot be Dismantled or salvaged

List Your Vehicle

Retirement Vehicle Information

Consumer Representations and Disclosures:

Eligibility Criteria

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