Dmv Form Vsa 10A PDF Details

The Gold Star License Plate Applicant Certification, known as form VSA 10A, serves a poignant purpose: to honor the immediate family members of those who have lost their lives in military service by granting them a special Gold Star license plate. This form, alongside the License Plate Application (VSA 10), represents a significant gesture of recognition from the state of Virginia, underscoring the profound sacrifices made by military personnel and their families. The legislation behind this initiative stipulates that close kin of service members who perished under specific conditions—ranging from any major conflicts from World War I to engagements post-July 1, 1958, including actions against enemies, military operations with opposing forces, or as a result of terrorist attacks recognized by the U.S. Secretary of Defense—may apply. These conditions are clearly listed on the form, ensuring that applicants can easily determine their eligibility. Applicants must also demonstrate their relationship to the deceased service member and their ownership of a motor vehicle, fulfilling requirements that underscore the personal and legal significance of the application process. It does not only symbolize the valor and sacrifice recognized by the issuance of these plates but also imposes on the applicants the gravity of submitting truthful information, as falsification is subject to felony prosecution under Virginia law.

QuestionAnswer
Form NameDmv Form Vsa 10A
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesVSA, commonwealths, false, Virginia

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GOLD STAR LICENSE PLATE APPLICANT CERTIFICATION

VSA 10A (07/01/2008)

Purpose: Immediate family members of individuals who have died in military service use this form (and the License Plate Application, VSA 10) to request a Gold Star license plate.

Instructions: Return the completed forms (VSA 10 and VSA 10A), with the applicable fees to any DMV customer service center. You may also mail the forms and fees to DMV at the above address.

PLATE INFORMATION

Virginia legislation provides that immediate family members of persons who have died in military service to their country can apply for special Gold Star license plates by submitting an application and written evidence that they are a motor vehicle owner and immediate family of a member of the armed forces of the United States who lost his or her life under any of the following conditions. Check the applicable condition.

During World War I, World War II, or any subsequent period of armed hostilities in which the United States was engaged before July 1, 1958, or

Anytime after June 30, 1958:

a. while engaged in an action against an enemy of the United States;

b. while engaged in military operations involving conflict with an opposing foreign force;

c. while serving with friendly forces engaged in an armed conflict in which the United States is not a belligerent

party against an opposing armed force; or

Anytime after March 28, 1973, as a result of:

a. an international terrorist attack against the United States or a foreign nation friendly to the United States,

recognized as such an attack by the U.S. Secretary of Defense; or

b. military operations while serving outside the United States, including commonwealths, territories, and

possessions of the United States, as part of a peacekeeping force.

The provisions of VA Code § 46.2-725 subdivisions B 1 and B 2 do not apply to Gold Star license plates.

APPLICANT INFORMATION

APPLICANT NAME

DECEASED SERVICE MEMBER NAME

APPLICANT RELATIONSHIP TO DECEASED SERVICE MEMBER (check applicable box)

Widow (remarried or not)

Stepmother

Foster parents who stood in loco parentis

Widower (remarried or not)

Stepfather

Child

Mother

Mother through adoption

Stepchild

Father

Father through adoption

Adopted child

Brother

Half brother Sister

Half sister

CERTIFICATION

I hereby certify that the information contained in this certification is true and correct to the best of my knowledge. I understand that it is unlawful to knowingly make a false statement and any violation may be prosecuted as a felony as provided in Virginia law.

APPLICANT SIGNATURE

DATE (mm/dd/yyyy)

How to Edit Dmv Form Vsa 10A Online for Free

Making use of the online tool for PDF editing by FormsPal, you'll be able to complete or edit VSA here and now. Our tool is constantly developing to grant the very best user experience possible, and that is thanks to our dedication to constant improvement and listening closely to user comments. With a few basic steps, you'll be able to start your PDF journey:

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It is actually simple to complete the document with our practical tutorial! This is what you need to do:

1. While filling in the VSA, make certain to incorporate all of the important fields in its relevant area. It will help to facilitate the process, allowing for your details to be handled quickly and correctly.

Find out how to fill out DMV step 1

2. The subsequent step would be to fill in all of the following blanks: APPLICANT NAME, DECEASED SERVICE MEMBER NAME, APPLICANT INFORMATION, APPLICANT RELATIONSHIP TO DECEASED, Widow remarried or not, Widower remarried or not, Mother Father, Stepmother Stepfather Mother, Foster parents who stood in loco, Brother Half brother Sister Half, I hereby certify that the, APPLICANT SIGNATURE, DATE mmddyyyy, and CERTIFICATION.

DMV completion process detailed (stage 2)

As to Stepmother Stepfather Mother and Foster parents who stood in loco, be sure that you take a second look in this section. Those two are certainly the most important ones in the PDF.

Step 3: Before moving on, make certain that all form fields have been filled out properly. Once you determine that it's fine, press “Done." Try a 7-day free trial option with us and obtain direct access to VSA - which you'll be able to then work with as you wish inside your FormsPal account page. FormsPal ensures your data confidentiality with a protected system that in no way records or shares any type of private data used in the file. You can relax knowing your files are kept confidential each time you work with our services!