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About VA Form 26-4555

Form name: Application in Acquiring Specially Adapted Housing or Special Home Adaptation Grant
Related to: Housing assistance
Form last updated: June 23, 2022

When to use this form

Use VA Form 26-4555 to apply for a Specially Adapted Housing grant or a Special Home Adaptation grant. The information you provide helps us determine or verify your eligibility for these disability housing grants.

Downloadable PDF

Download VA Form 26-4555 (PDF)