Motor-vehicle adaptive equipment
Applies for qualifying adaptive motor-vehicle equipment through Veterans Health Administration channels.
Automobile allowance and adaptive equipment
Application for Automobile or Other Conveyance and Adaptive Equipment
Applies for an automobile or conveyance allowance and/or qualifying adaptive equipment.
Purpose and use
Use when applying for this special disability benefit under current VA eligibility rules.
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
- online and 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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