OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Application for Automobile or Other Conveyance and Adaptive Equipment (Under 38 U.S.C. 3901-3904) (VA Form 21-4502)

OMB 2900-0067 ยท VA.

OMB 2900-0067

VA Form 21-4502 is used by veterans and servicepersons to apply for automobile or other conveyance benefits. Without the information solicited by this form, VA would be unable to determine eligibility, and benefits would not be properly paid.

The latest form for Application for Automobile or Other Conveyance and Adaptive Equipment (Under 38 U.S.C. 3901-3904) (VA Form 21-4502) expires 2027-08-31 and is listed under ICR 202404-2900-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 21-4502 Application for Automobile or Other Conveyance and Adaptive Equipment (Under 38 U.S.C. 3901-3904) (VA Form 21-4502)Form
30-Day FRN - 2900-0067 (2024).pdf Supplementary Document
2024-09728, 60-Day FRN (2900-0067), VAF21-4502.pdf Supplementary Document
2900-0067, Supporting Statement (VAF21-4502).docxSupporting Statement A
Application for Automobile or Other Conveyance and Adaptive Equipment (Under 38 U.S.C. 3901-3904) (VA Form 21-4502) Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202404-2900-002 Revision of a currently approved collection 2024-07-16 Approved with change
202009-2900-022 Reinstatement with change of a previously approved collection 2021-06-03 Approved without change
201712-2900-004 Extension without change of a currently approved collection 2017-12-07 Approved without change
201408-2900-015 Revision of a currently approved collection 2014-10-15 Approved without change
201404-2900-013 Revision of a currently approved collection 2014-07-30 Withdrawn and continue
201401-2900-007 Revision of a currently approved collection 2014-02-28 Withdrawn and continue
201309-2900-008 Revision of a currently approved collection 2013-09-19 Withdrawn and continue
201107-2900-005 Extension without change of a currently approved collection 2011-10-06 Approved without change
200802-2900-008 Extension without change of a currently approved collection 2008-08-22 Approved without change
200511-2900-010 Extension without change of a currently approved collection 2005-11-18 Approved without change
200211-2900-007 Extension without change of a currently approved collection 2002-11-08 Approved without change
200003-2900-009 Extension without change of a currently approved collection 2000-03-20 Approved without change
199701-2900-004 Extension without change of a currently approved collection 1997-01-24 Approved without change
199311-2900-009 Extension without change of a currently approved collection 1993-11-08 Approved without change
199012-2900-001 Revision of a currently approved collection 1990-12-03 Approved without change
198711-2900-006 Extension without change of a currently approved collection 1987-11-23 Approved without change
198501-2900-004 Reinstatement with change of a previously approved collection 1985-01-02 Approved without change
198112-2900-006 Revision of a currently approved collection 1981-12-30 Approved without change
198101-2900-021 No material or nonsubstantive change to a currently approved collection 1981-01-22 Approved with change
197703-2900-007 Revision of a currently approved collection 1977-03-31 Approved without change
197510-2900-012 Revision of a currently approved collection 1975-10-14 Approved without change
197502-2900-004 Revision of a currently approved collection 1975-02-07 Approved without change