Background Shortage of organs for transplantation is still considered to be a global concern, especially in developing countries such as Iran. Identifying factors contributing to the individual's decision to be a donor in a given society is critical to address the shortage of organ donors. The purpose of this study was to use a culturally modified Organ Donation Model (ODM) to explore the significant factors and ways in which these factors could influence signing the donor card.Methods This study was a cross-sectional design conducted among 600 employees from 57 offices in Hamadan, in the west of Iran, in 2018. Participants were selected randomly and surveyed on being a donor and as well on their perceptions regarding signing the donor card. Structural equation modeling (SEM) was conducted to determine the inter-relationship between the studied variables.Results: The mean age of participants was 39.5 (SD=7.0). Twenty percent of participants (n=120) had a signed donor card. Overall structural model provided a good fit with the data[χ2= 1172.964 (df=643, p<0.001), CFI=0.910, TLI= 0.902, RMSEA=0.037 (90% CI, 0.034 - 0.040). descriptive norms (β= 0.53, p<0.001), non-cognitive beliefs (i.e; Jinx factor, Ick factor, mistrust to medical system and body integrity (β= -0.33, p<0.001), anticipated regret (β= 0.28, p<0.001) and subjective norms (β= -0.17, p<0.01) had significant direct effects on signing the donor card.Conclusions This study provides socio-culturally informed evidence on individuals' signing donor card. To combat the shortage of organs for transplantation, these factors could provide a guide to policymakers in developing the community- based interventions.