Va form 10 1394-2025

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The document is an application form for veterans seeking adaptive equipment for motor vehicles, authorized under Title 38, U.S.C. It outlines the information required to determine eligibility for benefits related to automotive adaptive equipment, including personal details, disabilities, and specific equipment requests. The form also includes instructions for both applicants and vendors regarding the submission process and reimbursement procedures.

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Click ‘Get Form’ to open VA Form 10-1394 in the editor.
Begin by filling out Part I, which includes your name and address, claim number, and social security number. Ensure all mandatory fields are completed accurately.
In section 7, check the applicable disabilities that affect your driving. This helps the VA understand your specific needs for adaptive equipment.
Provide details about the vehicle requiring modifications in section 8. Include make, model, and vehicle identification number (VIN).
List the adaptive equipment you are requesting in section 10. Be sure to include estimated costs for each item to facilitate processing.
Complete the payment information in section 11, indicating where payments should be made and attaching any necessary invoices.
Finally, sign and date the form in sections 13 and 24 to certify receipt of services or items authorized.

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2015	4.3 Satisfied (27 Votes)
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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What VA form do I use for temporary 100% disability?

please complete and submit VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits.

Who is eligible for the VA automobile allowance?

If you have a disability related to your service that prevents you from driving, you may be able to get money to help you buy or change a vehicle so you can drive.

Can I use my VA disability to buy a car?

Form 4502 is used to apply for the VA vehicle grant. It must be filled out correctly and submitted for a 100% service-connected disabled veteran to obtain the benefit. Upon approval, eligible veterans will receive $26,417.20 (as of 10-1-2024), which can be used to purchase a vehicle.

What is the VA Form 10 1394?

Youll need to fill out an Application for Adaptive EquipmentMotor Vehicle (VA Form 10-1394). Bring it to the prosthetic representative at your local VA medical center. We may pay you, or we may pay the equipment seller directly. Note: You must have a service-connected disability to get an adaptive-equipment grant.

What is a VA 10 form?

Use VA Form 10-10EZ if youre a Veteran and want to apply for VA health care. You must be enrolled in VA health care to get care at VA health facilities or to have us cover your care at a community care provider (an approved non-VA provider).

va 1394

va form 10-1394 pdf va form 21-4502 VA Auto grant requirements va form 21-4502 pdf VA auto grant requirements PDF VA automobile grant fact sheet How much is the VA automobile grant VA AUTO Act

How much does VA pay for adaptive equipment?

Mobility Device Securement Electronic Securement Occupied Driver$2,194 Electronic Securement Unoccupied Fold-Out Installation $2,104 Electronic Securement Unoccupied In-Floor Installation $2,110 Electronic Securement Unoccupied Manual Wheelchair Only $2,097 Retractable Strap Securement Occupied $55212 more rows