Form VSA 54 PDF Details

Send the completed form for validation to a Veterans Services Officer, then submit the validated form with your registration application to DMV.

Medical certification: medical certification is required (the medical professional sections of this form); a disabled plate also requires Form VSA 10.

Boxes: check the appropriate box(es) if you are applying for a sales and use tax exemption, placard displaying the international symbol of access, and/or license plate.

Physician only: may be completed and signed by a Veteran Services physician or the applicant's choice of physician, physician's assistant, nurse practitioner.

Chiropractor or podiatrist only: may be completed and signed by the applicant's choice of chiropractor or podiatrist.

QuestionAnswer
Form NameForm VSA 54
Form Length1 page
Fillable?Yes
Fillable fields77
Avg. time to fill out13 min
EditionRev 07/01/2026
Where to sendVeterans Services Officer, 210 Franklin Road, S.W., Roanoke, VA 24011, for validation
Matches the agency's fileYes, checked October 3, 2026
Other namesVSA 54, VSA54, Form VSA 54, VSA 54 certification of disability, Veteran Certification of Disability, Virginia DMV VSA 54
Official sourceForm VSA 54 (Rev 07/01/2026), Virginia Department of Motor Vehicles