About VA Form 21-4502
- Form name: Application for Automobile or Other Conveyance and Adaptive Equipment (UNDER 38 U.S.C. 3901-3904)
- Related to: Disability
- Form last updated: June 2022
When to use this form
Use VA Form 21-4502 if you’re a Veteran with a disability and you want to apply for compensation for a vehicle that meets your needs. This may include a specially equipped vehicle for you to drive or adaptive equipment to help you get in and out of your vehicle.
Downloadable PDFDownload VA Form 21-4502 (PDF)
Helpful links related to VA Form 21-4502
Eligibility for VA disability benefits
Find out if you qualify for compensation for a presumptive disability or other service-connected conditions.
How to file a VA disability claim
Find out how to file a claim for disability compensation or increased disability compensation.
File additional forms for your disability claim
Find out if you need to complete additional forms for your disability claim.
VA automobile allowance and adaptive equipment
Find out if you can get a VA automobile allowance if you’re a Veteran living with a service-connected disability that prevents you from driving.