Va Automobile Adaptive Equipment Form

If you qualify for adaptive equipment only you ll need to fill out an application for adaptive equipment motor vehicle va form 10 1394.

Va automobile adaptive equipment form.

Veterans are trained through the va driver s rehabilitation program how to safely operate their vehicle on our nation s roadways. If va determines you are eligible read the instructions on va form 21 4502 for a list of adaptive equipment preapproved for particular disabilities. Part i to be completed by applicant if more space is needed attach a separate sheet and identify by item number 4. Obtain the original copy of va form 21 4502 from the veteran or servicemember after he or she has completed section iv.

Application for adaptive equipment motor vehicle. Deliver the vehicle including va approved adaptive equipment provided and or installed by the seller. Purchase a vehicle. Date of va certificate of eligibility.

All van modifications require prior authorization before purchase. The automobile adaptive equipment aae program permits physically challenged persons to enter exit and or operate a motor vehicle or other conveyance. Driver s license verification check applicable block 6. Request for dd 214 or other military records nara sf 180.