VA Form 22-1999 VA Enrollment Certification

What Is VA Form 22-1999?

VA Form 22-1999, Enrollment Certification is a document issued by the Department of Veterans Affairs (VA) in order to determine the student's eligibility for education benefits, as well as the proper amount.

The latest version of the form was released by the VA in March 2009. An up-to-date fillable version of the VA Form 22-1999 - also known as the GI Bill Form 22-1999 - is available for digital filing and download below or can be found on the VA official website.

The completing of the paper is voluntary. However, if the requested information is not provided, the VA will not be able to pay the student any education benefits. All the responses are confidential.

VA Form 22-1999c, Certificate of Affirmation of Enrollment Agreement - Correspondence Course is a related form used to pay education benefits for the correspondence training.

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OMB Control No. 2900-0073
Respondent Burden: 10 minutes
INSTRUCTIONS AND CERTIFICATIONS FOR
VA ENROLLMENT CERTIFICATION (VA FORM 22-1999)
IMPORTANT: Use Side A for Institutions of Higher Learning (IHL) or schools providing non-college degree (NCD)
training. Use Side B for flight, correspondence, and apprenticeship or on-the-job training programs. Use the VA-ONCE (VA
Online Certification) application to file this information electronically. Contact your Education Liaison Representative (ELR)
for assistance.
Read the Certifications below before completing EITHER Items 19D and 19E on Side A OR Items 12D and 12E on Side
B. COMPLETE ONLY ONE SIDE OF THIS FORM. If completing Side B, pull out the carbon and reverse before
completing that side. Ensure that VA Copy 1 is on top.
CERTIFICATIONS
IT IS HEREBY CERTIFIED THAT:
(1) This institution has exercised reasonable diligence in meeting all applicable requirements of Title 38, U.S. Code, and any failure by the
institution to meet any requirements of the law will be reported promptly to VA;
(2) The course or courses certified are approved by the State Approving agency and are generally acceptable to meet requirements for the
student's educational, professional, or vocational objective;
(3) No course certified is a repetition of any course previously satisfactorily completed except as permitted by VA regulations;
(4) This institution holds no power of attorney agreement authorizing the institution to negotiate VA educational assistance allowance
checks;
(5) FOR PRIVATELY OWNED SCHOOLS: The student certified is not an owner or officer of the school nor is the student certified an
official authorized to sign enrollment certifications;
(6) This institution agrees to report promptly to VA any enrollment change and any change due to unsatisfactory progress, conduct, or
attendance. Promptly means within 30 days of the enrollment change. (Except for students receiving benefits under chapter 33, the
institution need not report an enrollment change for a student who was in full-time attendance before the change and in full-time attendance
after the enrollment change.);
(7) Check "Yes," if the student is a Yellow Ribbon Program participant;
(8) FOR ENROLLMENTS UNDER CHAPTERS 30, 32, 1606, and 1607: All the 85-15 ratio requirements have been satisfied.
INSTITUTIONS OF HIGHER LEARNING OR SCHOOLS PROVIDING NON-COLLEGE DEGREE TRAINING
IT IS HEREBY CERTIFIED THAT:
(9) FOR ENROLLMENTS REQUESTING ADVANCE PAYMENT: It is agreed that the initial check for this enrollment period will be
mailed to the school for temporary care and delivery to the student upon registration but not more than 30 days before the commencement
of training. It is understood that the completion of a certificate of delivery will normally be required upon delivery of the advance payment;
(10) IF CERTIFYING "GUEST STUDENT", place the name of the primary institution in Item 17, "Remarks";
(11) FOR NONCREDIT DEFICIENCY, REMEDIAL, OR REFRESHER COURSES: The courses certified in Item 9B are needed by the
student in order to pursue a program of education at this institution.
(12) YELLOW RIBBON PROGRAM: If applicable, enter the amount of Yellow Ribbon Program contributions your institution is making
on behalf of the student for each term, quarter, or semester.
FLIGHT TRAINING
IT IS HEREBY CERTIFIED THAT:
(13) The student has a private pilot's certificate. I certify that a copy of the student's class II medical certificate as of the beginning date of
the course is on file at this institution. If the student is enrolled in an Airline Transport Pilot course, I certify that a copy of the student's
valid class I medical certificate as of the beginning date of the course is on file at this institution. For all initial enrollment certifications, I
have placed the name and date of the medical certificate in Item 11, "Remarks" on Side B.
APPRENTICESHIP AND OTHER OJT PROGRAMS
IT IS HEREBY CERTIFIED THAT:
(14) The employer will immediately notify VA once the trainee receives the journeyman wage. Exceptions to this rule include training on a
Davis-Bacon job, or a job in a geographic location with a different wage scale.
SPECIAL INSTRUCTIONS
ADVANCE PAYMENT INFORMATION -
Veterans and other claimants must complete Items 15A and 15B on Side A to request
an advance payment of education benefits. Upon receipt of a timely request and enrollment information, VA will pay the veteran or
claimant an advance payment of his or her education benefits. An advance payment is part of the first month and the second month's
education benefits. VA will send the payment to the veteran's school for delivery to the veteran or other claimant upon entry into training.
ACCELERATED PAYMENT INFORMATION -
Claimants must complete Items 16A and 16B on Side A to request an
accelerated payment. Chapter 30, 1606, and 1607 beneficiaries (or beneficiaries receiving transfer-of-entitlement benefits under these
chapters) qualify for an accelerated payment. An accelerated payment can only be paid under chapter 30 to claimants in a high technology
program. (A list of programs is on the Internet at "www.gibill.va.gov".) An accelerated payment can only be paid under chapters 1606 or
1607 for claimants pursuing a program to qualify for accelerated payment, the cost of the program must exceed twice the amount of
education benefits otherwise payable for that training.
VA FORM
22-1999
SUPERSEDES VA FORM 22-1999, DEC 2007,
MAR 2009
WHICH WILL NOT BE USED.
OMB Control No. 2900-0073
Respondent Burden: 10 minutes
INSTRUCTIONS AND CERTIFICATIONS FOR
VA ENROLLMENT CERTIFICATION (VA FORM 22-1999)
IMPORTANT: Use Side A for Institutions of Higher Learning (IHL) or schools providing non-college degree (NCD)
training. Use Side B for flight, correspondence, and apprenticeship or on-the-job training programs. Use the VA-ONCE (VA
Online Certification) application to file this information electronically. Contact your Education Liaison Representative (ELR)
for assistance.
Read the Certifications below before completing EITHER Items 19D and 19E on Side A OR Items 12D and 12E on Side
B. COMPLETE ONLY ONE SIDE OF THIS FORM. If completing Side B, pull out the carbon and reverse before
completing that side. Ensure that VA Copy 1 is on top.
CERTIFICATIONS
IT IS HEREBY CERTIFIED THAT:
(1) This institution has exercised reasonable diligence in meeting all applicable requirements of Title 38, U.S. Code, and any failure by the
institution to meet any requirements of the law will be reported promptly to VA;
(2) The course or courses certified are approved by the State Approving agency and are generally acceptable to meet requirements for the
student's educational, professional, or vocational objective;
(3) No course certified is a repetition of any course previously satisfactorily completed except as permitted by VA regulations;
(4) This institution holds no power of attorney agreement authorizing the institution to negotiate VA educational assistance allowance
checks;
(5) FOR PRIVATELY OWNED SCHOOLS: The student certified is not an owner or officer of the school nor is the student certified an
official authorized to sign enrollment certifications;
(6) This institution agrees to report promptly to VA any enrollment change and any change due to unsatisfactory progress, conduct, or
attendance. Promptly means within 30 days of the enrollment change. (Except for students receiving benefits under chapter 33, the
institution need not report an enrollment change for a student who was in full-time attendance before the change and in full-time attendance
after the enrollment change.);
(7) Check "Yes," if the student is a Yellow Ribbon Program participant;
(8) FOR ENROLLMENTS UNDER CHAPTERS 30, 32, 1606, and 1607: All the 85-15 ratio requirements have been satisfied.
INSTITUTIONS OF HIGHER LEARNING OR SCHOOLS PROVIDING NON-COLLEGE DEGREE TRAINING
IT IS HEREBY CERTIFIED THAT:
(9) FOR ENROLLMENTS REQUESTING ADVANCE PAYMENT: It is agreed that the initial check for this enrollment period will be
mailed to the school for temporary care and delivery to the student upon registration but not more than 30 days before the commencement
of training. It is understood that the completion of a certificate of delivery will normally be required upon delivery of the advance payment;
(10) IF CERTIFYING "GUEST STUDENT", place the name of the primary institution in Item 17, "Remarks";
(11) FOR NONCREDIT DEFICIENCY, REMEDIAL, OR REFRESHER COURSES: The courses certified in Item 9B are needed by the
student in order to pursue a program of education at this institution.
(12) YELLOW RIBBON PROGRAM: If applicable, enter the amount of Yellow Ribbon Program contributions your institution is making
on behalf of the student for each term, quarter, or semester.
FLIGHT TRAINING
IT IS HEREBY CERTIFIED THAT:
(13) The student has a private pilot's certificate. I certify that a copy of the student's class II medical certificate as of the beginning date of
the course is on file at this institution. If the student is enrolled in an Airline Transport Pilot course, I certify that a copy of the student's
valid class I medical certificate as of the beginning date of the course is on file at this institution. For all initial enrollment certifications, I
have placed the name and date of the medical certificate in Item 11, "Remarks" on Side B.
APPRENTICESHIP AND OTHER OJT PROGRAMS
IT IS HEREBY CERTIFIED THAT:
(14) The employer will immediately notify VA once the trainee receives the journeyman wage. Exceptions to this rule include training on a
Davis-Bacon job, or a job in a geographic location with a different wage scale.
SPECIAL INSTRUCTIONS
ADVANCE PAYMENT INFORMATION -
Veterans and other claimants must complete Items 15A and 15B on Side A to request
an advance payment of education benefits. Upon receipt of a timely request and enrollment information, VA will pay the veteran or
claimant an advance payment of his or her education benefits. An advance payment is part of the first month and the second month's
education benefits. VA will send the payment to the veteran's school for delivery to the veteran or other claimant upon entry into training.
ACCELERATED PAYMENT INFORMATION -
Claimants must complete Items 16A and 16B on Side A to request an
accelerated payment. Chapter 30, 1606, and 1607 beneficiaries (or beneficiaries receiving transfer-of-entitlement benefits under these
chapters) qualify for an accelerated payment. An accelerated payment can only be paid under chapter 30 to claimants in a high technology
program. (A list of programs is on the Internet at "www.gibill.va.gov".) An accelerated payment can only be paid under chapters 1606 or
1607 for claimants pursuing a program to qualify for accelerated payment, the cost of the program must exceed twice the amount of
education benefits otherwise payable for that training.
VA FORM
22-1999
SUPERSEDES VA FORM 22-1999, DEC 2007,
MAR 2009
WHICH WILL NOT BE USED.
Privacy Act Notice: VA will not disclose information collected on this form to any source other than what has been authorized under the
Privacy Act of 1974 or Title 38, Code of Federal Regulations 1.576 for routine uses (i.e., VA sends educational forms or letters with a
veteran's identifying information to the veteran's school or training establishment to (1) assist the veteran in the completion of claims
forms or (2) VA obtains further information as may be necessary from the school for VA to properly process the veteran's education
claim or to monitor his or her progress during training) as identified in the VA system of records, 58VA21/22/28, Compensation,
Pension, Education and Vocational Rehabilitation Records - VA, and published in the Federal Register. Your obligation to respond is
required to obtain or retain benefits. While you do not have to respond, VA cannot pay the student any further education benefits until we
receive the information. We cannot pay the student any education benefits until we receive this information (38 U.S.C. 3684). Your
responses are confidential (38 U.S.C. 5701). Information submitted is subject to verification through computer matching programs with
other agencies.
Respondent Burden: We need this information to determine the student's eligibility for education benefits and the proper amount payable.
Title 38, United States Code, allows us to ask for this information. We cannot pay the student any education benefits until we receive this
information which schools are required to submit (38 U.S.C. 3684). We estimate that you will need an average of 10 minutes to review
the instructions, find the information, and complete this form. VA cannot conduct or sponsor a collection of information unless a valid
OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid
OMB control numbers can be located on the OMB Internet Page at www.whitehouse.gov/omb/library/OMBINV.html#VA. If desired,
you can call 1-888-GI-BILL-1 (1-888-442-4551) to get information on where to send comments or suggestions about this form.
VA FORM 22-1999, MAR 2009
OMB Control No. 2900-0073
NOTE: Tear off and read the Instruction and Certification Sheet before completing the form.
Respondent Burden: 10 minutes
Side
A
VA ENROLLMENT CERTIFICATION
IMPORTANT: Side A is for Institutions of Higher Learning or schools offering non-degree training.
(First, Middle, Last)
(For chapter 35, include suffix. For Transferability
1. NAME OF STUDENT
2. VA FILE NO.
cases, enter the veteran's social security number)
3. CURRENT ADDRESS OF STUDENT
(If not entered in
4. SOCIAL SECURITY NUMBER OF STUDENT
Item 2)
5. TYPE OF TRAINING
6A. NAME OF PROGRAM
UNDERGRADUATE COLLEGE DEGREE
FARM COOPERATIVE
(For VA
6B. IS STUDENT MATRICULATED AT YOUR FACILITY?
purposes, a student is matriculated when formally admitted as
GRADUATE OR ADVANCED
a degree seeking student)
HIGH SCHOOL
PROFESSIONAL
(Not Farm)
YES
NO
COOPERATIVE
NON-COLLEGE DEGREE
6C. IS PARENT SCHOOL LETTER ON FILE?
GUEST STUDENT
(Supplemental School)
YES
NO
(Complete Item 6C)
7. YELLOW RIBBON RECIPIENT
YES
NO
ENROLLMENT DATA
9. COURSES TAKEN
13. TRAINING
10. CLOCK
12. YELLOW
8. ENROLLMENT EFFECTIVE
CREDIT HOUR COURSE(S)
NON-CREDIT
11. CHARGES
TIME
DATES
HOURS
FOR PERIODS
RIBBON
(Graduate or
TAKEN BY
REMEDIAL/
(Month, Day, Year)
PROGRAM
TAKEN
PER WEEK
OF INSTRUCTION
Advanced
DISTANCE
DEFICIENCY/
IN-RESIDENCE
Professional
LEARNING
REFRESHER
Program)
A. HOURS
A. BEGIN
B. END
B. HOURS
C. HOURS
HOURS
A.TUITION
B. FEES
AMOUNT
14. ADDITIONAL INFORMATION FOR HIGH SCHOOL AND FARM CO-OP COURSES
(Enter the number of high
(Is student pursuing course concurrently with substantially
A. HIGH SCHOOLS APPROVED ON A UNIT BASIS
B. FARM CO-OP ONLY
school units for which the student is enrolled)
full-time agricultural employment averaging at least 40 hours per week?)
YES
NO
ADVANCE PAYMENT REQUEST - (Note: Advance payment is not accelerated payment.) (See Special Instructions.)
15A. SIGNATURE OF STUDENT
15B. DATE SIGNED
I REQUEST AN
ADVANCE PAYMENT
ACCELERATED PAYMENT REQUEST
(Note: Accelerated payment is not advance payment.) (See Special Instructions.)
I request accelerated payment. I certify that I intend to seek employment in one of the following industries: Biotechnology, Life Science Technologies,
Opto-electronics, Computers and Telecommunications, Electronics, Computer-integrated Manufacturing, Material Design, Aerospace, Weapons, or
Nuclear Technology.
16A. SIGNATURE OF STUDENT
16B. DATE SIGNED
I REQUEST AN
ACCELERATED PAYMENT
17. REMARKS
NOTE - Complete Item 18 only if course(s) are contracted out to another school or are given at a branch location other than shown in Item 19B. Do not
complete Item 18 if course(s) are taken at a branch or extension of a school as defined in 38 CFR 21.4266(c).
18. NAME AND ADDRESS OF CONTRACT SCHOOL OR BRANCH LOCATION
CERTIFICATIONS - The provisions described in paragraphs (1) through (14) on the attached sheet are certified.
19A. FACILITY CODE
19B. SCHOOL NAME AND ADDRESS
19C. TELEPHONE NUMBER OF CERTIFYING OFFICIAL
19D. SIGNATURE OF CERTIFYING OFFICIAL
19E. DATE SIGNED
VA FORM
22-1999
SUPERSEDES VA FORM 22-1999, DEC 2007,
MAR 2009
WHICH WILL NOT BE USED.
OMB Control No. 2900-0073
NOTE: Tear off the Instructions and Certifications sheet before completing the form.
Respondent Burden: 10 minutes
Side
B
VA ENROLLMENT CERTIFICATION
IMPORTANT: Side B is for flight, correspondence, and apprenticeship or on-the-job training programs.
(For chapter 35, include suffix. For transferability
(First, Middle, Last)
2. VA FILE NO.
1. NAME OF STUDENT
cases, enter the veteran's social security number)
(If not entered in
3. CURRENT ADDRESS OF STUDENT
4. SOCIAL SECURITY NUMBER OF STUDENT
Item 2)
5. NAME OF PROGRAM
6. TYPE OF TRAINING
(Not Flight
7. CREDIT FOR PREVIOUS TRAINING
)
FLIGHT TRAINING
CORRESPONDENCE
APPRENTICESHIP OR OTHER ON-THE-JOB
VOCATIONAL FLIGHT TRAINING (See Instructions)
8A. CREDIT ALLOWED FOR PREVIOUS EDUCATION AND TRAINING
8B. DATE TRAINING BEGAN
IN CURRENT COURSE
DUAL
SOLO
GROUND SCHOOL
CERTIFICATES AND RATINGS
8C. NUMBER OF HOURS/UNITS OF INSTRUCTION IN CURRENT COURSE
8D. TOTAL CHARGES
PRE- AND POST
DUAL
SOLO
GROUND SCHOOL
OTHER
FLIGHT
$
CORRESPONDENCE TRAINING
IMPORTANT: A VA Form 22-1999c, Certificate of Affirmation of Enrollment Agreement, MUST be signed by this student
and accompany this certification form before VA can authorize payment for this correspondence course.
9A. DATE FIRST LESSON
9B. NUMBER OF LESSONS FOR
9C. CHARGE PER LESSON TO
9D. WERE ANY LESSONS SERVICED BEFORE THE
SENT TO STUDENT
WHICH STUDENT IS ENROLLED
STUDENT
DATE ENTERED IN ITEM 9A?
(If "Yes," show lesson number and
YES
NO
date serviced in Item 11, "Remarks")
APPRENTICESHIP AND OTHER ON-THE-JOB TRAINING
IMPORTANT: A signed copy of the training agreement outlining the training program and wage scale as approved by the State
Approving agency or VA, or for apprentices, any document signed by the trainee incorporating this agreement by reference must be
attached to this form. (Show monthly number of hours worked to date in Item 11, "Remarks.")
10B. TYPE OF TRAINING
10A. TRAINING DATES
10C. NUMBER OF HOURS
10D. NUMBER OF HOURS IN
(Month, Day, Year)
TRAINEE IS EMPLOYED PER WEEK
STANDARD WORK WEEK
IN TRAINING PROGRAM
BEGINNING
ENDING
APPRENTICESHIP
HRS.
HRS.
HRS.
HRS.
OTHER-ON-THE-JOB
HRS.
HRS.
11. REMARKS
CERTIFICATIONS - The provisions described in paragraphs (1) through (14) on the attached sheet are certified.
12A. FACILITY CODE
12B. SCHOOL NAME AND ADDRESS
12C. TELEPHONE NUMBER OF CERTIFYING OFFICIAL
12D. SIGNATURE OF CERTIFYING OFFICIAL
12E. DATE SIGNED
VA FORM
22-1999
SUPERSEDES VA FORM 22-1999, DEC 2007,
MAR 2009
WHICH WILL NOT BE USED.

Download VA Form 22-1999 VA Enrollment Certification

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VA Form 22-1999 Instructions

The instructions for filling out the document are provided on its first page. They should be read carefully before completing the paper, detached, and kept for further references. It is not required to fill out the document unless it contains a valid OMB control number.

In addition to instructions, the document includes two sides that are considered as the separate Enrollment Certifications. Side A of VA Form 22-1999 should be used for Institutions of Higher Learning or schools providing non-college degree training. Side B is designed for flight, correspondence, and apprenticeship or on-the-job training programs. Only one of these sides must be completed.

When completing the Side B, it is necessary to pull out and reverse the copy-paper first. Before starting to fill out the paper, it is required to ensure that Copy 1 is on top.

How to Fill out VA Form 22-1999?

The document is easy to complete, as most of its fields are self-explanatory. It takes about 10 minutes to look through the instructions, find the data, and fill out the paper. The completion instructions are as follows:

  1. Items 1 through 4 on both sides of the document require the student's information. It is obligatory to provide the correct and up-to-date address, as checks and other correspondence from the VA will be sent to it. The File number may concur with student's Social Security number (SSN). If not, the student's SSN should be indicated in Item 4.
  2. Items 5 through 6 of both sides are self-explanatory and refer to the type of training, name of the program that was approved by the VA, matriculation, and parent school letter.
  3. If the student is a Yellow Ribbon Program participant, it must be indicated in Item 7 on Side A.
  4. Item 7 on Side B requires an indication of the prior credit. It is not allowed to leave this field blank when completing the Side B. If the evaluation is not completed yet, it is necessary to put "Pending". If no prior credit is granted, "0" or "None" should be entered.
  5. The Section "Enrollment Data" on the Side A Should contain the detailed information about the enrollment, including beginning and end dates, duration of courses taken, charges, and Yellow Ribbon Program contribution amount (if applicable).
  6. If the student requests the advanced payment of education benefits, Items 15A and B on the Side A should be completed.
  7. If the student requests the accelerated payments, it is required to fill out Items 16A and B on Side A. The accelerated payments may be provided to Chapter 30, 1606, and 1607 beneficiaries only.
  8. For certification of a guest student, it is necessary to indicate the name of the primary institution in Item 17, "Remarks".
  9. For the document to be valid, it should be signed by the certifying official. The student signs the Enrollment Certification only if requesting accelerated or advance payments.

Where to Mail VA Form 22-1999?

The completed Enrollment Certification should be mailed to the VA. Besides, it can be filled out and submitted electronically via VA-ONCE. For more information and assistance, it is required to contact the Education Liaison Representative. The document can be submitted 120 days before the term begins.

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