Letter text
An In Reply Refer To line, a greeting, the list of item(s) on loan, and the note that any additional remarks or comments go on the back of the letter.
FL-10-426
Temporary Loan Follow-up Letter
- Agency
- VA
- Revision
- February 2005
- Fillable fields
- 4
- Pages
- 1
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form FL-10-426: Temporary Loan Follow-up Letter
VA Form FL-10-426 is the U.S. Department of Veterans Affairs Temporary Loan Follow-up Letter. VA's page lists it as related to VHA. It is a form letter from VA to a Veteran who, the letter says, has been furnished the listed item(s) on loan. The letter says items still in use may be retained for as long as they are needed, and items no longer used or needed are to be returned for possible use by another veteran.
The letter is one page. The top has an In Reply Refer To line, a greeting and space for the list of loaned items. The Veteran answers six questions about the items, signs, dates and returns the letter, with any extra remarks on the back. The form says response to the letter is voluntary and failure to respond will have no adverse effect on benefits. You can fill out the PDF free in your browser on this page and download the result without an account.
What's on VA Form FL-10-426
Questions 1 and 2: satisfaction and use
Whether the item(s) have been satisfactory, yes or no with a no explained on the reverse, and how often they have been used: never, 2 or 3 times, or as often as needed.
Questions 3 and 4: condition and need
The present condition of the item(s), from not usable, fair and good to excellent, and whether the item(s) are still needed, yes or no.
Questions 5 and 6: time and return
How much longer the items are needed (6 months, 1 year or longer than 1 year), completed only after a yes to question 4, and whether the items can be brought or sent to VA.
Signature and notice
The Signature of Veteran and Date lines, and a Paperwork Reduction Act notice with OMB No. 2900-0188, an average time of 1 minute and an expiration date of 11/30/2007.
How to answer VA Form FL-10-426
- 1
Check the item list
Read the list of item(s) the letter says were furnished on loan.
- 2
Answer questions 1 to 4
Mark one box for each question. The form says a no to question 1 is explained on the reverse.
- 3
Answer question 5 or 6
Complete question 5 only after a yes to question 4. If the items are no longer needed, question 6 asks about bringing or sending them to VA.
- 4
Add remarks on the back
The letter says to use the back of the letter for any additional remarks or comments.
- 5
Sign, date and return
Sign the Signature of Veteran line, enter the date and return the letter to VA, as the letter asks.
Why fill Form FL-10-426 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the VA, not a copy someone retyped
- Works on a phone, tablet or computer
Returning the letter
Where it goes
The letter says to answer the questions and return the letter to us, the VA office that sent it. It prints no mailing address.
Returning the items
If the Veteran cannot bring or send the items to VA, the form says the VA will arrange to pick up the item(s) at the Veteran's home.
Voluntary response
The form says response to this letter is voluntary and failure to respond will have no adverse effect on benefits to which you might otherwise be entitled.
Edition
The PDF footer reads FL 10-426 FEB 2005 (R). It shows OMB No. 2900-0188 with an expiration date of 11/30/2007.
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Who uses VA Form FL-10-426?
VA sends the letter, and the Veteran who has the loaned items answers it.
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Questions about Form FL-10-426
What is VA Form FL-10-426?
It is VA's Temporary Loan Follow-up Letter. It asks a Veteran who was furnished items on loan whether they are satisfactory, how often they are used, their condition and whether they are still needed.
Who fills out VA Form FL-10-426?
VA sends the letter. The Veteran it is addressed to answers the six questions, signs the Signature of Veteran line, dates it and returns it.
Can I keep the items on loan?
The letter says items still in use may be retained for as long as they are needed. Items no longer used or needed are returned for possible use by another veteran.
Is a response required?
The form says response to this letter is voluntary and failure to respond will have no adverse effect on benefits to which you might otherwise be entitled.
What if I cannot bring the items back?
Question 6 asks if you can bring or send the items to VA. The form says that if the answer is no, the VA will arrange to pick up the item(s) at your home.
Where do I send VA Form FL-10-426?
The letter says to return it to the VA office that sent it. The form prints no mailing address.