VA Form 22-1990E Application for Family Member to Use Transferred Benefits

VA Form 22-1990E is a U.S. Department of Veterans Affairs form also known as the "Application For Family Member To Use Transferred Benefits". The latest edition of the form was released in December 1, 2016 and is available for digital filing.

Download a PDF version of the VA Form 22-1990E down below or find it on U.S. Department of Veterans Affairs Forms website.

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APPLICATION FOR FAMILY MEMBER TO USE TRANSFERRED BENEFITS
Use this form to apply for Transfer of Entitlement (TOE) to basic educational assistance under chapters 30 and 33 of title 38, U.S. Code
and chapters 1606 and 1607 of title 10, U.S. Code. Use this form only if you are a dependent of an individual eligible to transfer benefits
to his or her dependents. The service member's military branch must have approved the request to transfer benefits. The eligible service
member must have designated you by name, the number of months transferred, and the period for which the transfer is effective.
Do not use this form to apply for benefits based upon your own military service. To apply for benefits based on your own service use,
VA Form 22-1990. That form can be downloaded at www.va.gov/vaforms, completed on-line and submitted electronically at
www.benefits.va.gov/gibill
(click "Apply On Line" and select the "Education" option). It can also be obtained from the nearest VA
regional office, and it may also be available where you received this application.
INFORMATION AND INSTRUCTIONS
FOR COMPLETING THE APPLICATION FOR VA EDUCATION BENEFITS TOE PROGRAM
VA VOCATIONAL AND EDUCATIONAL COUNSELING HELP AVAILABLE - If you need help planning your individual
educational and career goals, VA offers a wide range of counseling services to help you make these decisions. Services include
educational and vocational guidance and such testing as necessary for you to develop a greater understanding of your skills, talents, and
interests. For further information on VA counseling, call VA toll-free at 1-888-GI-BILL-1 (1-888-442-4551) or TDD at the Federal
Relay number 711.
NOTE: The numbers on the instructions match the item numbers on the application. Items not mentioned are self-explanatory.
Part II
ITEM 7. The Department of Treasury requires all Federal benefit payments be made by electronic funds transfer (EFT), also called
direct deposit. Please attach a voided personal check or deposit slip or provide the information requested below to enroll in direct
deposit. If you do not have a bank account, you must receive your payment through Direct Express Debit MasterCard. To request a
Direct Express Debit Mastercard, you must apply at
www.usdirectexpress.com
or by telephone at 1-800-333-1795. If you elect not to
enroll, you must contact representatives handling waiver requests for the Department of Treasury at 1-888-224-2950. They will address
any questions or concerns you may have and encourage your participation in EFT.
ITEM 9A. Select the benefit transferred to you.
ITEM 9B. Self explanatory, except for the following items:
"Vocational Flight Training." You must already have a private pilot's license. If you are taking an Airline Transport Pilot course, you
must have a valid first-class medical certificate on the date that you enter training. For all other flight courses, you must have a valid
second-class medical certificate on the date that you enter training.
"National Test Reimbursement." You can be reimbursed for the cost of approved tests for admission to or credit at institutions of higher
learning.
"Licensing or Certification Test Reimbursement." A licensing test is a test offered by a state, local, or federal agency which is required by
law to practice an occupation. A certification test is a test designed to provide affirmation of an individual's qualifications in a specific
occupation. Examples include EMT, CPA, MCSE, CCNP, etc.
ADDITIONAL HELP
If you need more help in completing this application, call VA TOLL FREE at 1-888-GI-BILL-1 (1-888-442-4551). If you use the
Telecommunications Device for the Deaf (TDD), the Federal Relay number is 711. You can also get education assistance after normal
business hours at our VA Education Internet site www.benefits.va.gov/gibill.
HOW TO FILE YOUR CLAIM
Be sure to do the following:
(A) If you have selected a school or training establishment:
Step 1: Mail the completed application to the VA Regional Processing Office for the region of that school's physical address. See page 2
for the addresses of these VA Regional Processing Offices.
Step 2: Tell the veterans certifying official at your school or training establishment that you have applied for VA education benefits. Ask
him or her to send your enrollment information using VA Form 22-1999, Enrollment Certification, or its electronic version.
Step 3: Wait for VA to process your application and notify you of its decision concerning your eligibility for education benefits.
(B) If you haven't selected a school or training establishment:
Step 1: Mail the completed application to the VA Regional Processing Office for the region of your home address. See page 2 for the
addresses of these VA Regional Processing Offices.
Step 2: Wait for VA to process your application and notify you of its decision concerning your eligibility for education benefits.
VA FORM
22-1990E
SUPERSEDES VA FORM 22-1990E, JUN 2013,
Page 1
DEC 2016
WHICH WILL NOT BE USED.
APPLICATION FOR FAMILY MEMBER TO USE TRANSFERRED BENEFITS
Use this form to apply for Transfer of Entitlement (TOE) to basic educational assistance under chapters 30 and 33 of title 38, U.S. Code
and chapters 1606 and 1607 of title 10, U.S. Code. Use this form only if you are a dependent of an individual eligible to transfer benefits
to his or her dependents. The service member's military branch must have approved the request to transfer benefits. The eligible service
member must have designated you by name, the number of months transferred, and the period for which the transfer is effective.
Do not use this form to apply for benefits based upon your own military service. To apply for benefits based on your own service use,
VA Form 22-1990. That form can be downloaded at www.va.gov/vaforms, completed on-line and submitted electronically at
www.benefits.va.gov/gibill
(click "Apply On Line" and select the "Education" option). It can also be obtained from the nearest VA
regional office, and it may also be available where you received this application.
INFORMATION AND INSTRUCTIONS
FOR COMPLETING THE APPLICATION FOR VA EDUCATION BENEFITS TOE PROGRAM
VA VOCATIONAL AND EDUCATIONAL COUNSELING HELP AVAILABLE - If you need help planning your individual
educational and career goals, VA offers a wide range of counseling services to help you make these decisions. Services include
educational and vocational guidance and such testing as necessary for you to develop a greater understanding of your skills, talents, and
interests. For further information on VA counseling, call VA toll-free at 1-888-GI-BILL-1 (1-888-442-4551) or TDD at the Federal
Relay number 711.
NOTE: The numbers on the instructions match the item numbers on the application. Items not mentioned are self-explanatory.
Part II
ITEM 7. The Department of Treasury requires all Federal benefit payments be made by electronic funds transfer (EFT), also called
direct deposit. Please attach a voided personal check or deposit slip or provide the information requested below to enroll in direct
deposit. If you do not have a bank account, you must receive your payment through Direct Express Debit MasterCard. To request a
Direct Express Debit Mastercard, you must apply at
www.usdirectexpress.com
or by telephone at 1-800-333-1795. If you elect not to
enroll, you must contact representatives handling waiver requests for the Department of Treasury at 1-888-224-2950. They will address
any questions or concerns you may have and encourage your participation in EFT.
ITEM 9A. Select the benefit transferred to you.
ITEM 9B. Self explanatory, except for the following items:
"Vocational Flight Training." You must already have a private pilot's license. If you are taking an Airline Transport Pilot course, you
must have a valid first-class medical certificate on the date that you enter training. For all other flight courses, you must have a valid
second-class medical certificate on the date that you enter training.
"National Test Reimbursement." You can be reimbursed for the cost of approved tests for admission to or credit at institutions of higher
learning.
"Licensing or Certification Test Reimbursement." A licensing test is a test offered by a state, local, or federal agency which is required by
law to practice an occupation. A certification test is a test designed to provide affirmation of an individual's qualifications in a specific
occupation. Examples include EMT, CPA, MCSE, CCNP, etc.
ADDITIONAL HELP
If you need more help in completing this application, call VA TOLL FREE at 1-888-GI-BILL-1 (1-888-442-4551). If you use the
Telecommunications Device for the Deaf (TDD), the Federal Relay number is 711. You can also get education assistance after normal
business hours at our VA Education Internet site www.benefits.va.gov/gibill.
HOW TO FILE YOUR CLAIM
Be sure to do the following:
(A) If you have selected a school or training establishment:
Step 1: Mail the completed application to the VA Regional Processing Office for the region of that school's physical address. See page 2
for the addresses of these VA Regional Processing Offices.
Step 2: Tell the veterans certifying official at your school or training establishment that you have applied for VA education benefits. Ask
him or her to send your enrollment information using VA Form 22-1999, Enrollment Certification, or its electronic version.
Step 3: Wait for VA to process your application and notify you of its decision concerning your eligibility for education benefits.
(B) If you haven't selected a school or training establishment:
Step 1: Mail the completed application to the VA Regional Processing Office for the region of your home address. See page 2 for the
addresses of these VA Regional Processing Offices.
Step 2: Wait for VA to process your application and notify you of its decision concerning your eligibility for education benefits.
VA FORM
22-1990E
SUPERSEDES VA FORM 22-1990E, JUN 2013,
Page 1
DEC 2016
WHICH WILL NOT BE USED.
Eastern Region:
VA Regional Office
P.O. Box 4616
Buffalo, NY 14240-4616
Serves the following states:
DC
MA
CT
DE
NC
NH
MD
ME
NJ
NY
PA
RI
VA
VT
US Virgin Islands
Foreign Schools
APO/FPO AA
Central Region:
VA Regional Office
P.O. Box 32432
St. Louis, MO 63132-0832
Serves the following states:
CO
IA
IL
IN
KS
KY
MI
MN
MO
MT
NE
ND
OH
SD
TN
WV
WI
WY
Western Region:
VA Regional Office
P.O. Box 8888
Muskogee, OK 74402-8888
Serves the following states:
AK
AL
AR
AZ
CA
FL
GA
HI
ID
LA
MS
NM
NV
OK
OR
PR
UT
WA
SC
TX
APO/FPO AP
Guam
Philippines
Privacy Act Notice: The 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, section 1.576 for routine uses (e.g., 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) for the VA to obtain further
information as may be necessary from the school for the 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 and Employment
Records - VA, published in the Federal Register. Your obligation to respond is required to obtain or retain education benefits. Giving us your SSN account
information is voluntary. Refusal to provide your SSN by itself will not result in the denial of benefits. The VA will not deny an individual benefits for
refusing to provide his or her SSN unless the disclosure of the SSN is required by a Federal Statute of law enacted before January 1, 1975, and still in effect.
The requested information is considered relevant and necessary to determine the maximum benefits under the law. While you do not have to respond, VA
cannot process your claim for education assistance unless the information is furnished as required by existing law (38 U.S.C. 3471). The responses you
submit are considered confidential (38 U.S.C. 5701). Any information provided by applicants, recipients, and others may be subject to verification through
computer matching programs with other agencies.
Respondent Burden: We need this information to determine your eligibility for education benefits (38 U.S.C. 3471). Title 38, United States Code, allows
us to ask for this information. We estimate that you will need an average of 15 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
http://www.reginfo.gov/public/do/PRAMain. If desired, you can call 1-800-827-1000 to get information on where to send comments or suggestions
about this form.
Page 2
VA FORM 22-1990E, DEC 2016
OMB Control No. 2900-0154
Respondent Burden: 15 minutes
Expiration Date: 12/31/2019
APPLICATION FOR FAMILY MEMBER TO USE TRANSFERRED BENEFITS
INTERNET VERSION AVAILABLE - You may complete and send your application over the Internet at:
www.benefits.va.gov/gibill.
PART I - APPLICANT INFORMATION
1. SOCIAL SECURITY NUMBER OF APPLICANT
2. SEX OF APPLICANT
3. APPLICANT'S DATE OF BIRTH
Month
Day
Year
MALE
FEMALE
(First, Middle Initial, Last)
4. NAME
5. APPLICANT'S ADDRESS
Number and Street
Apt./Unit Number
City, State, ZIP Code
(Include Area Code)
6A. APPLICANT'S TELEPHONE NUMBERS
Primary:
Secondary:
(If applicable)
6B. APPLICANT'S E-MAIL ADDRESS
(Attach a voided personal check or provide the following information. See instructions for additional Direct Deposit information.)
7. DIRECT DEPOSIT
Routing or Transit Number
Account Type
Account Number
Checking
Savings
8A. RELATIONSHIP TO SERVICE MEMBER
8B. DID YOU RECEIVE A HIGH SCHOOL DIPLOMA OR HIGH SCHOOL EQUIVALENCY CERTIFICATE?
(If "Yes," provide date)
SPOUSE
CHILD
YES
DATE:
NO
PART II - BENEFIT TRANSFERRED AND TYPE AND PROGRAM OF EDUCATION OR TRAINING
(Select one box)
(See instructions for additional information)
9A. BENEFIT TRANSFERRED TO YOU
9B. TYPE OF EDUCATION OR TRAINING
(Including on-line courses)
CHAPTER 33 - POST-9/11 GI BILL
COLLEGE OR OTHER SCHOOL
VOCATIONAL FLIGHT TRAINING
CHAPTER 30 - MONTGOMERY GI BILL EDUCATIONAL
(SAT, CLEP, ETC.)
NATIONAL TEST REIMBURSEMENT
ASSISTANCE PROGRAM (MGIB)
LICENSING OR CERTIFICATION TEST REIMBURSEMENT
CHAPTER 1606 - MONTGOMERY GI BILL-SELECTED
(MCSE, CCNA, EMT, NCLEX, ETC.)
RESERVE EDUCATIONAL ASSISTANCE PROGRAM (MGIB-SR)
APPRENTICESHIP OR ON-THE-JOB
CHAPTER 1607 - RESERVE EDUCATIONAL ASSISTANCE
CORRESPONDENCE
PROGRAM (REAP)
TUITION ASSISTANCE TOP-UP
9C. FULL NAME AND ADDRESS OF SCHOOL, IF KNOWN
VA DATE STAMP
(Do Not Write In This Space)
(e.g. Bachelor of Arts in Accounting,
9D. PLEASE SPECIFY YOUR EDUCATIONAL OR CAREER OBJECTIVE, IF KNOWN
welding certificate, police officer, etc.)
VA FORM
22-1990E
SUPERSEDES VA FORM 22-1990E, JUN 2013,
Page 3
DEC 2016
WHICH WILL NOT BE USED.
PART III - EDUCATION AND EMPLOYMENT INFORMATION
(If "Yes," specify below)
10A. DO YOU HOLD ANY FAA FLIGHT CERTIFICATES?
YES
NO
(Including apprenticeship, on-the-job training, and flight training)
10B. EDUCATION AFTER HIGH SCHOOL
NUMBER AND
NAME AND LOCATION OF
DATES OF TRAINING
DEGREE, DIPLOMA, OR
MAJOR FIELD OR
TYPE OF HOURS
COLLEGE OR OTHER
(Semester, Quarter
CERTIFICATE RECEIVED
COURSE OF STUDY
TRAINING PROVIDER
FROM
TO
or Clock)
(Only complete if you held a license or journeyman rating to practice a profession)
10C. EMPLOYMENT
EMPLOYMENT
PRINCIPAL OCCUPATION
NUMBER OF MONTHS WORKED
LICENSE OR RATING
JOB 1 SINCE HIGH SCHOOL
JOB 2 SINCE HIGH SCHOOL
PART IV - ENTITLEMENT TO AND USAGE OF ADDITIONAL TYPES OF ASSISTANCE
11A. FOR APPLICANTS ON ACTIVE DUTY ONLY: Are you receiving or do you anticipate receiving any money
YES
NO
(including but not limited to Federal Tuition Assistance)
from the Armed Forces or Public Health Service
for the course for which you have applied to the VA for education benefits?
11B. FOR APPLICANTS WHO ARE CIVILIAN EMPLOYEES OF THE U.S. GOVERNMENT ONLY:
(including but not limited to the Government
Are you receiving or do you anticipate receiving any money
YES
NO
Employees Training Act)
from your Agency for the same period for which you have applied to the VA for
education benefits? If you will receive such benefits during any part of your training, check "YES."
PART V - SERVICE MEMBER INFORMATION
12. SERVICE MEMBER'S SOCIAL SECURITY NUMBER
13. SERVICE MEMBER'S BRANCH OF SERVICE
(First, Middle Initial, Last)
14. SERVICE MEMBER'S NAME
15. SERVICE MEMBER'S ADDRESS
Number and Street
Apt./Unit Number
City, State, ZIP Code
PART VI - CERTIFICATION AND SIGNATURE OF APPLICANT
I CERTIFY THAT all statements in my application are true and correct to the best of my knowledge and belief. If on active duty, I also certify that I
have consulted with an Education Service Officer (ESO) regarding my education program.
PENALTY - Willful false statements as to a material fact in a claim for education benefits is a punishable offense and may result in the forfeiture of
these or other benefits and in criminal penalties.
16A. SIGNATURE OF APPLICANT (DO NOT PRINT)
16B. DATE SIGNED
Page 4
VA FORM 22-1990E, DEC 2016

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