Fill Out The Forms

Download the form pack below and fill out completely. Then continue to step two to determine what supplemental information we need to complete your request.

Gather Additional Documents

1. A clear copy of your driver’s license or state identification card;
2. Proof of income such as W2, pay stub, benefits statement (SSI,
   SSDI, VA) etc.
3. An estimate, 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.

kate.wallace@rehab.alabama.gov

Southern Disability Foundation
P.O. Box 1566
Montgomery, AL 36102