Aims 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 cross-sectional study was conducted among 600 employees from 57 offices in Hamadan, Iran, in 2018. Participants were selected randomly and surveyed on being a donor and their perceptions regarding signing the donor card. Structural equation modeling (SEM) was conducted to determine the inter-relationship between the studied variables. Results Participants’ mean age was 39.5 (SD = 7.0). 20% of participants had a signed donor card. Descriptive norms (β = 0.53, p < 0.001), non-cognitive beliefs (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. Conclusion This study provides socio-culturally informed evidence on individuals' signing donor card. These factors could provide a guide to policymakers to develop the community-based interventions.