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* Form name: Application for Automobile or Other Conveyance and Adaptive Equipment (UNDER 38 U.S.C. 3901-3904) Form revision date: August 2024 Related to: Disability 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 PDF Download VA Form 21-4502 (PDF) * Find out if you qualify for compensation for a presumptive
disability or other service-connected conditions. * Find out how to file a claim for disability compensation or increased disability compensation. * Find out if you need to complete
additional forms for your disability claim. * 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.