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LearnmoreaboutForthosewhoalreadyfiledaclaimforVAdisability,useVAForm“ApplicationforAutomobileorOtherConveyanceandAdaptive Equipment”whenapplyingforMakesurethatSectionIIIofVAFormiscompletedandsignedbyVADeliverthevehicle,includingVA-approvedadaptive equipmentprovidedand/or•VAForm,ApplicationforAutomobileorOtherConveyanceandAdaptiveEquipmentGetFormWorkingwiththisformhasnever beenObtaintheoriginalcopyofVAFormfromtheveteranorservicememberafterheorshehascompletedSectionIVSubmittheoriginalcopyofVAForm anditemizedinvoicetotheVAregionalofficeshowninItem,SectionIII,Attention:FinancialDivisionYou’llneedtofilloutanApplicationforAutomobileor OtherConveyanceandAdaptiveEquipment(VAForm)We’llpaythevehicle’ssellerdirectlyHowitworksForSURVIVORSBENEFITStherequiredforms are:VAFormPEZ,LearnhowtoapplyforVAdisabilitybenefitswiththisformthathelpsyoudetermineyoureligibilityandcompensationforservice-connected conditions, VAFormPrintable,FillableinPDF–AVAForm,alsoknownasanAuthorizationforAutomobileorOtherConveyanceandAdaptiveUseava formtemplatetomakeyourdocumentworkflowmorestreamlined.Note:Youmusthaveaservice-connectedconditiontogetaspeciallyequippedvehicle.Ifyou haven’tMakesurethatSectionIIofVAFormiscompletedandsignedbyVADeliverthevehicle,includingVA-approvedadaptiveequipmentprovidedand/or installedbythesellerObtaintheoriginalcopyofVAFormfromtheveteranorservicepersonafterheorshehascompletedSectionIIITheinstructionsontheVA Formcontainalistofadaptiveequipmentthathasbeenpre-approvedforparticulardisabilitiesNote:AfteryoucompleteandsubmitSectionIoftheapplication, VAwillcompleteSectionIIandreturntheoriginaltoyouSearchforVAformsbykeyword,formname,orformnumberQuicklyaccesstoptasksforfrequently downloadedVAformsContactshouldbemadewiththeProstheticsServiceatyourlocalVAmedicalcenteroroutpatientclinicpriortoanypurchaseof equipmentCompletealliteminPartIofthisforminduplicateandsigntheformIfyouarerequestingadaptiveequipmentorservices,VAwilldetermineyour eligibilityandcompletePartIIMakesurethatSectionIIIofVAFormiscompletedandsignedbyVADeliverthevehicle,includingVA-approvedadaptive equipmentprovidedand/orinstalledbythesellerObtaintheoriginalcopyofVAFormfromtheveteranorservicememberafterheorshehascompletedSection IVSubmittheoriginalcopyofVAIfyouhaveanyquestions,visittheAskVA(AVA)sitetoaskaquestionelectronicallyTheVAwillmakeaonetimepaymentto eligibleVeteranstobuyanautomobileorforadaptiveequipment,repairorreplacementrequiredduetoadisabilityGetVAFormtodownloadDetermineyour eligibilityforthisbenefitOpenformfollowtheinstructionsVaFormisaVAformrequestingtheveterantoprovideinformationaboutenrollmentinelementaryor secondaryschool, AnApplicationforAutomobileorOtherConveyanceandAdaptiveEquipment(VAForm)GetVAFormtodownloadShowdetailsMail ittotheaddresslistedontheform.