Automobile allowance and adaptive equipment
Applies for an automobile or conveyance allowance and/or qualifying adaptive equipment.
Motor-vehicle adaptive equipment
Application for Adaptive Equipment—Motor Vehicle
Applies for qualifying adaptive motor-vehicle equipment through Veterans Health Administration channels.
Purpose and use
Use when VA directs you to request qualifying vehicle adaptive equipment after reviewing current eligibility and authorization steps.
When not to use it
Do not use this form for a different benefit or review path unless current VA instructions identify it for that purpose.
Who completes and signs it?
- Completed by
- veteran or claimant
- Signed by
- veteran or claimant
- Availability
- official pdf
- Submission
- follow current form instructions
Always start with the official page
Open the current VA version.
Check the revision, instructions, signature requirements, and delivery options immediately before use.
Read before use
Important limitations
- Verify the current revision and submission instructions on the official VA page before signing or sending the form.
- This planner identifies forms that may fit a situation; it does not determine eligibility or filing strategy.
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