How to Fill Out and Submit the GM Accessibility Reimbursement Form

The GM Accessibility Reimbursement form gets you back up to $1,500 for adaptive equipment installed on a new Chevrolet, Buick, Cadillac, or GMC vehicle. To claim it, you fill out GM’s application, attach your installer’s itemized paid invoice, bring the vehicle to a GM dealer for an inspection signature, and send the whole package to GM by fax or email within six months of your purchase or lease date. The program covers eligible 2024, 2025, and 2026 model-year vehicles, with the offer running through January 4, 2027.¹

Before You Start the Form

Three things need to be true before the application is worth filling out. The vehicle has to be a new, unused Chevrolet, Buick, Cadillac, or GMC. The equipment has to be permanently mounted, address a permanent disability, and be purchased from and installed by a licensed equipment installer. And the adaptation and claim both have to happen within six months of your purchase or lease date. Miss that window and the claim is disqualified.¹²

Qualifying modifications include wheelchair lifts, ramps, hand controls, power-assisted seating, and lowered-floor conversions. Regular production options and GM accessories do not qualify. A handful of items need extra paperwork: assist steps, running boards, assist handles, and electric parking brakes require a letter from your physician describing the limitations of your disability. If your modification is on that short list, get the doctor’s letter before you start.¹

If you leased the vehicle, you’ll also need a letter of authorization from your leasing company to include with the application.²

Filling Out the Application

Download the form from the GM Fleet accessibility page or the Chevrolet website. Use blue or black ink. The form has three main sections: purchaser information, vehicle and dealer details, and dealer confirmation.²

Purchaser Information

Enter your full name, mailing address, phone numbers, and email. Check the box for your transaction type: retail sale, retail lease, or commercial sale. The program is not limited to personal-use vehicles. The name you write has to match the name on your purchase or lease agreement, because the vehicle owner of record is the one who signs the application.²

Vehicle and Dealer Details

Fill in your Vehicle Identification Number (VIN) from your sales contract or registration. The dealer section asks for the dealership’s name and BAC (Business Associate Code). Both appear on your original sales contract. If you’ve misplaced it, call the dealership and ask for the BAC directly.²

Signature

The vehicle owner of record signs and dates the application at the bottom of the purchaser section. If two names are on the title, both should sign.

Documents to Attach

The form by itself is not a complete claim. Gather these before you take the vehicle to a GM dealer for the inspection step:

An itemized paid invoice from your installer. It needs the installer’s preprinted company name, address, and phone number; your name, address, and phone number; the VIN; a description of the adaptive equipment; the installation date; and parts and labor costs listed as separate line items.
Proof of payment, such as a credit card receipt, canceled check, or paid invoice showing the equipment is fully paid for.
A lessor authorization letter if the vehicle is leased.
A physician’s letter if your equipment is assist steps, running boards, assist handles, or an electric parking brake.

The invoice is where most applications stall. GM wants parts and labor broken out, not combined into a single total. If your installer handed you a lump-sum invoice, ask them to reissue it with the costs separated before you submit anything.²

Getting the Dealer Signature

After the equipment is installed but before you submit, take the adapted vehicle and your completed form to a GM dealer. A dealer representative inspects the vehicle, confirms the equipment is in place, and signs the dealer confirmation section of the form. The dealer does not have to be the one who sold you the vehicle; any GM dealership can do the inspection. Call ahead and say you need a mobility reimbursement inspection so the right person is available when you arrive.²

If your dealership is applying the $1,500 as a credit at the time of purchase instead of having GM mail you a check, the dealer has to include one of the following with the application: a Customer Incentive Acknowledgment or Assignment Form, a copy of the dealer’s check issued to the adaptive equipment installer, or a copy of the sales contract showing the accessibility incentive deduction.²

How to Submit

Once the dealer has signed and your documents are assembled, send the full package one of two ways:

Fax: 1-866-234-3036
Email: mobility@gm.com

No physical mail is required. Keep copies of everything. If you fax, print the transmission confirmation. If you email, send the documents as PDF attachments and keep the sent message.²

After You Submit

GM reviews the application to verify vehicle eligibility, equipment type, installer credentials, and invoice details. The three most common reasons claims get delayed are a missing dealer signature, an invoice that doesn’t itemize parts and labor separately, and a submission that arrives after the six-month deadline. If approved, GM issues the reimbursement of up to $1,500. Watch your mail or whatever payment arrangement you set up with the dealer, and follow up if you haven’t heard anything within several weeks.¹

For questions about your claim’s status or help completing the form, call the GM Accessibility Assistance Center at 1-800-323-9935.

1
GM Fleet. Wheelchair Accessible Vans, Cars & Trucks – GM Accessibility
2
General Motors. GM Accessibility Reimbursement Application