Check out the steps below to see
Fill Out The Forms
Download the application documents below and fill out completely. Then continue to step two to determine what supplemental information we need to complete your request.
Gather Additional Documents
- A clear copy or photo of your driver’s license (front & back) or state identification card;
- A clear copy or photo of your proof of income such as W2, pay stub, benefits statement (SSI,
SSDI, VA) etc.
- An estimate, purchase order or bill of sale from the vendor detailing the specific costs of the
assistive technology, vehicle, or home modifications for which you
are seeking the loan.
Submit Your Completed Forms and Documents
You can submit your completed forms and documents to the email address or P.O. Box below.