The VSD 001 form is a document used in California for verifying veteran status and service-connected disabilities. It is essential for veterans seeking a driver license or identification card with a veteran designation. Completing this form accurately ensures that veterans receive the benefits and recognition they deserve.
Offer and Acceptance Form Reiwa - Maintaining clear communication with the property manager will be beneficial throughout the process.
When engaging in activities that could potentially lead to injuries or damages, it is crucial to utilize a legal safeguard such as the Release of Liability form. This form ensures that participants are aware of the risks involved and agree not to hold the provider accountable for any incidents that may arise. For those looking to complete this essential document, you can access it through California PDF Forms for your convenience and protection.
Annual Summary and Transmittal of U.S. Information Returns - Any corrections to the forms submitted must be noted on a new Form 1096.
State of California
Veteran Status and Service-Connected Disability Verification
SECTION 1 - TO BE COMPLETED BY THE APPLICANT REQUESTING VETERAN STATUS AND/OR SERVICE CONNECTED DISABLITY VERIFICATION PRINT USING BLUE OR BLACK INK
FIRST NAME
MIDDLE NAME
LAST NAME
SUFFIX
DRIVER LICENSE OR IDENTIFICATION NUMBER
STATE OF ISSUANCE
DATE OF BIRTH (MM/DD/YYYY)
EMAIL ADDRESS
DAYTIME TELEPHONE NUMBER
MAILING ADDRESS
CITY
STATE
ZIP CODE
RESIDENCE ADDRESS IF DIFFERENT FROM MAILING ADDRESS ABOVE
SECTION 2 - APPLICANT CERTIFICATION
I certify (or declare) under penalty of perjury under the laws of the State of California, that I have served in the United States uniformed services and received an other than dishonorable discharge, or served in a Guard or Reserve component and was mobilized for federal active duty. The information I provided is true and correct. I authorize County Veterans Service Office (CVSO) employees, officers, and designees to verify the documents presented.
APPLICANT SIGNATURE
_
DATE
SECTION 3 - TO BE COMPLETED BY AUTHORIZED COUNTY VETERANS SERVICE OFFICE EMPLOYEE, OFFICER, OR DESIGNEE
COUNTY VETERANS SERVICE OFFICE ADDRESS
PHONE NUMBER
COUNTY
As a representative of the County Veterans Service Office of the above named county, and designee of the California Department of Veterans Affairs, I certify under penalty of perjury under the laws of the State of California, that I have reviewed the documentation required and that the above named individual meets the qualifications noted above.
COUNTY VETERANS SERVICE OFFICE REPRESENTATIVE'S SIGNATURE
COUNTY VETERANS SERVICE OFFICE REPRESENTATIVE'S PRINTED NAME
TITLE
This form must be submitted in person to the Department of Motor Vehicles along with an application for a driver license or identification card in compliance with California Vehicle Code § 12811 (c)(5) and all requirements must be met prior to the issuance of a driver license or identification card with a veteran designation on the face of the card. In addition to any other fee, a $5 fee must be paid for the veteran designation.
SECTION 4 -
DISABLED VETERAN CERTIFICATION FOR DISABLED VETERAN LICENSE PLATES
TO BE COMPLETED BY AUTHORIZED COUNTY VETERANS SERVICE OFFICE EMPLOYEE, OFFICER, OR
DESIGNEE
The above named applicant is a disabled veteran who, as a result of injury or disease suffered while on active service with the armed forces of the United States, suffers from one or more of the following disabilities:
•Has a disability which has been rated at 100% by the United States Department of Veterans Affairs, due to a diagnosed disease or disorder which substantially impairs or interferes with mobility.
•Is so severely disabled as to be unable to move without the aid of an assistant device.
•Has lost, or has lost use of, one or more limbs.
•Has suffered permanent blindness, as defined in Section 19153 of the Welfare and Institutions Code.
SECTION 5 - TO BE COMPLETED BY AUTHORIZED COUNTY VETERANS SERVICE OFFICE EMPLOYEE, OFFICER, OR DESIGNEE
As a representative of the County Veterans Service Office of the above named county, and designee of the California Department of Veterans Affairs, I certify under penalty of perjury under the laws of the State of California, that I have reviewed the documents
for the above named applicant that demonstrate that the applicant meets the qualifications noted above.
If this form is being submitted for an application for disabled veteran license plates only, this form and all other requirements, including acceptable proof of true full name and date of birth, may be submitted in person or by mail . For more information, please visit www.dmv.ca.gov.
FOR DMV USE ONLY
TECHNICIAN'S INITIALS/TECH ID #
DATELINE STAMP
APPLICANT'S DL/ID NUMBER
VSD-001 (Rev. 1/2021)
This form is not transferable
When applying for veteran status or service-connected disability verification in California, the VSD 001 form is essential. However, several other documents and forms are often used alongside it to ensure a smooth application process. Understanding these additional documents can help applicants navigate the requirements more effectively.
By familiarizing yourself with these accompanying documents, you can streamline your application process for veteran status and service-connected disability verification. Each form plays a vital role in ensuring that your application is complete and accurately reflects your service and needs.