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The VSD 001 form is an essential document for veterans in California seeking to verify their status and service-connected disabilities. This form serves multiple purposes, primarily allowing applicants to request recognition as veterans or to obtain a disabled veteran designation for their driver's license or identification card. It consists of several sections, starting with the applicant's personal information, including their name, contact details, and military service history. The applicant must certify their service under penalty of perjury, confirming that they have received an honorable discharge or were mobilized for federal active duty. Furthermore, a representative from the County Veterans Service Office must complete additional sections to validate the information provided. This form is crucial for those wishing to access various benefits and services available to veterans, including specialized license plates and veteran designations on identification cards. Additionally, it outlines the necessary fees and submission guidelines, ensuring that applicants are well-informed about the process. By understanding the key components of the VSD 001 form, veterans can navigate the verification process more effectively and secure the benefits they deserve.

Common mistakes

  1. Using the Wrong Ink Color: Many applicants mistakenly use ink colors other than blue or black. This can lead to delays or rejection of the application.

  2. Incomplete Personal Information: Failing to fill out all required fields, such as the first name, last name, or date of birth, is a common oversight. Every section must be completed to ensure the application is processed smoothly.

  3. Incorrect Signature: Some individuals forget to sign the form or may sign in a different name than what is listed on the application. The signature must match the name provided to avoid complications.

  4. Missing Contact Information: Not providing a daytime telephone number or email address can hinder communication. It's essential to include these details for any follow-up questions or clarifications.

  5. Failing to Certify Under Penalty of Perjury: Applicants sometimes overlook the certification statement in Section 2. This declaration is crucial and must be acknowledged to validate the application.

  6. Not Submitting in Person: For those applying for a driver license or identification card, submitting the form by mail instead of in person can lead to immediate rejection. The form must be presented at the DMV.

  7. Ignoring the Fee Requirement: Some applicants forget to include the $5 fee for the veteran designation. This fee is mandatory and must be paid at the time of submission.

  8. Providing Inaccurate Disability Information: When applying for disabled veteran license plates, applicants may misrepresent their disabilities. Accurate documentation and truthful representation are vital to avoid legal issues.

Preview - Vsd 001 Form

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

CITY

STATE

ZIP CODE

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

CITY

STATE

ZIP CODE

PHONE NUMBER

COUNTY

EMAIL ADDRESS

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

DATE

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

COUNTY VETERANS SERVICE OFFICE ADDRESS

CITY

STATE

ZIP CODE

PHONE NUMBER

COUNTY

EMAIL ADDRESS

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.

COUNTY VETERANS SERVICE OFFICE REPRESENTATIVE'S SIGNATURE

DATE

COUNTY VETERANS SERVICE OFFICE REPRESENTATIVE'S PRINTED NAME

TITLE

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

Documents used along the form

The VSD 001 form is essential for verifying veteran status and service-connected disabilities in California. Along with this form, several other documents may be required or beneficial for various applications. Below is a list of these documents, along with a brief description of each.

  • DD Form 214: This document serves as a certificate of release or discharge from active duty. It provides proof of military service and is often required for veteran benefits.
  • Mobile Home Bill of Sale: This form is essential for transferring ownership of a mobile home and serves as proof of the transaction, outlining important details such as the sale price, names of the buyer and seller, and a description of the mobile home. For more information, visit the Mobile Home Bill of Sale.
  • VA Rating Decision: This letter from the Department of Veterans Affairs outlines the disability rating assigned to a veteran. It confirms eligibility for certain benefits based on the severity of the service-connected disability.
  • Application for Veteran Benefits (VA Form 21-526EZ): This form is used to apply for disability compensation and other benefits. It collects information about the veteran's service and disabilities.
  • California Driver License Application: This application must be completed when applying for a driver license or identification card. It includes personal information and is submitted to the DMV.
  • Proof of Identity: Acceptable documents include a birth certificate, passport, or another government-issued ID. These documents verify the applicant's identity and date of birth.
  • Medical Records: Documentation of service-related injuries or conditions may be required. These records support claims for disability benefits and can include treatment history.
  • County Veterans Service Office (CVSO) Referral: A referral from a CVSO can assist in navigating the benefits process. This document may outline available resources and support for veterans.
  • Income Verification Documents: Proof of income may be needed for certain benefits or programs. This could include pay stubs, tax returns, or Social Security statements.
  • Application for Disabled Veteran License Plates: This specific application is used to request special license plates for disabled veterans, confirming eligibility based on the criteria set forth by the DMV.

These documents complement the VSD 001 form and play a critical role in accessing various benefits and services available to veterans. Ensuring that all required paperwork is completed accurately can streamline the process and enhance eligibility for the support veterans deserve.

Similar forms

The DD Form 214, or Certificate of Release or Discharge from Active Duty, is a crucial document for veterans. It provides a detailed account of a service member's military history, including dates of service, discharge status, and awards received. Like the VSD 001 form, the DD Form 214 serves as proof of military service, which is essential for various benefits and verifications. Both forms require accurate information and signatures to confirm the applicant's veteran status, ensuring that only eligible individuals receive the benefits they deserve.

The VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, is another important document for veterans seeking benefits. This form allows veterans to apply for disability compensation based on service-related injuries or illnesses. Similar to the VSD 001, it requires personal information and a certification of service. Both forms are designed to streamline the process of verifying a veteran's status and eligibility for benefits, ensuring that the information provided is accurate and verifiable.

The Wisconsin Motorcycle Bill of Sale form is essential for documenting the sale or transfer of a motorcycle, much like other important documents that veterans rely on for verifying their status and securing benefits. For those interested in motorcycle transactions, the form ensures the legal exchange of ownership in Wisconsin and can be found at autobillofsaleform.com/motorcycle-bill-of-sale-form/wisconsin-motorcycle-bill-of-sale-form/, highlighting its significance in protecting both sellers and buyers throughout the process.

The VA Form 21-4138, Statement in Support of Claim, is used by veterans to provide additional information or evidence to support their claims for benefits. This form is often submitted alongside the VSD 001 to bolster the veteran's application for service-connected disability verification. Both documents require the veteran to attest to the truthfulness of the information provided, reinforcing the importance of integrity in the claims process.

The VA Form 10-10EZ, Application for Health Benefits, allows veterans to apply for health care benefits through the Department of Veterans Affairs. Similar to the VSD 001 form, it requires personal information and verification of military service. Both forms are essential in determining eligibility for benefits, ensuring that veterans receive the necessary support for their health and well-being.

The VA Form 21-534EZ, Application for DIC, Death Pension, and Accrued Benefits, is for surviving spouses and dependents of veterans. This form helps them apply for benefits after the veteran's passing. Like the VSD 001, it requires documentation of the veteran's service and a certification of eligibility. Both forms aim to provide assistance to those who have served or are connected to those who have served, ensuring that families receive the benefits they need.

The VA Form 21-0779, Request for Nursing Home Information, is used to gather information about a veteran's need for nursing home care. This form is similar to the VSD 001 in that it requires verification of the veteran's service and eligibility for benefits. Both forms are part of the broader system that helps veterans access necessary services and support, reflecting the commitment to care for those who have served.

The VA Form 22-1990, Application for VA Education Benefits, allows veterans to apply for educational assistance. Like the VSD 001, it requires personal information and verification of military service. Both forms play a critical role in ensuring that veterans can access the benefits they are entitled to, whether for education or other forms of support, thus helping them transition successfully into civilian life.

The VA Form 21-0845, Authorization to Disclose Personal Information to a Third Party, enables veterans to authorize someone else to access their personal information. This form is akin to the VSD 001 in that it requires the veteran's consent and personal details. Both documents emphasize the importance of privacy and control over personal information while facilitating the process of obtaining benefits and services.

Dos and Don'ts

When filling out the VSD 001 form, it's important to follow specific guidelines to ensure your application is processed smoothly. Here are some dos and don'ts to keep in mind:

  • Do print your information using blue or black ink.
  • Do include your full name, date of birth, and contact information accurately.
  • Do sign and date the certification section.
  • Do provide any required documentation to verify your veteran status.
  • Do submit the form in person at the Department of Motor Vehicles.
  • Don't leave any sections blank; fill out all required fields.
  • Don't use a pencil or any ink color other than blue or black.
  • Don't forget to pay the $5 fee for the veteran designation.
  • Don't submit the form without the necessary supporting documents.
  • Don't assume that the form can be submitted by mail unless it's for disabled veteran license plates only.

Key takeaways

Here are key takeaways about filling out and using the VSD 001 form for veteran status and service-connected disability verification in California:

  • The form must be completed in blue or black ink.
  • Applicants should provide their full name, including any suffixes.
  • Include your driver license or identification number and the state of issuance.
  • Date of birth must be formatted as MM/DD/YYYY.
  • Contact information, including email address and daytime telephone number, is required.
  • Applicants must certify their military service under penalty of perjury.
  • The form must be submitted in person to the Department of Motor Vehicles (DMV).
  • A $5 fee is required for the veteran designation on the driver license or identification card.
  • Disabled veterans must have documentation verifying their disability status from the County Veterans Service Office.
  • This form is not transferable and should be submitted with the appropriate application for license plates if applicable.

For further details, applicants can visit the DMV website at www.dmv.ca.gov.

How to Use Vsd 001

Completing the VSD 001 form is a straightforward process, but it requires careful attention to detail. This form is essential for verifying veteran status and service-connected disabilities in California. After filling out the form, it must be submitted in person to the Department of Motor Vehicles along with your application for a driver license or identification card.

  1. Gather Required Information: Before starting, collect all necessary personal information, including your full name, date of birth, email address, and contact numbers.
  2. Complete Section 1: In this section, print your first name, middle name, last name, and suffix. Provide your driver license or identification number, state of issuance, date of birth (in MM/DD/YYYY format), email address, daytime telephone number, and mailing address. If your residence address differs from your mailing address, include that information as well.
  3. Sign Section 2: Read the certification statement carefully. Sign and date the form to confirm that the information you provided is true and correct. This section certifies your service in the United States uniformed services.
  4. County Veterans Service Office Completion: An authorized representative from the County Veterans Service Office will fill out Section 3. Ensure that they provide their signature, date, printed name, and title after reviewing your documentation.
  5. Disabled Veteran Certification (if applicable): If you are applying for disabled veteran license plates, Section 4 must be completed by a County Veterans Service Office representative. This section confirms your disability status as per the criteria listed.
  6. Final Review and Submission: Double-check all sections for accuracy and completeness. Once confirmed, submit the form in person to the DMV along with your application for a driver license or identification card. Remember to pay the additional $5 fee for the veteran designation.

After completing these steps, you will have successfully filled out the VSD 001 form. Ensure that all required documents are ready for submission, and visit the DMV to complete your application process.