Download VA Form 22-5495 Dependents' Request for Change of Program or Place of Training
Instructions for VA Form 22-5495
VA Form 22-5495 is distributed with information and filling guidelines provided on the fourth page of the form. The instructions for completing the form can be found below.
How to Fill out VA Form 22-5495?
The form - also known as the VA Benefits Form 22-5495 - consists of five parts in total:
- Part I. Applicant Information. Provide your full name, social security number, VA file number, gender, date of birth, current mailing address, phone number(s), and email address. This part also requires your direct deposit information and name, address and phone number of your emergency contact.
- Part II. Qualifying Individual Information. This section contains information about the person, on whose account the benefits are being claimed. This includes their full name, social security number or VA file number, a branch of service, date of birth, date of death or date listed as MIA or POW, applicant's relationship to qualifying the individual. An applicant must state if the qualifying individual is currently on active duty or if they or the applicant has an outstanding felony or warrant.
- Part III. Applicant's Military Service information. If you have ever served on active duty in the Armed Forces, enter information about your periods of active service, branch of service or reserve or guard component, and character of discharge.
- Part IV. Benefit and Type of Education or Training. Fill out this section by providing information on educational benefits. Enter the type of benefit, type of training, education or career objective, the name of the program you request to pursue, name and complete address of old, current, and new school or training establishment, reasons why training at the old or current school or training establishment stopped or will stop.
- Part V. Remarks and Certification. This section provides for additional commentary and remarks and certification that all statements in the application are true and correct to the best of the applicant's knowledge and belief.
How to Submit VA Form 22-5495 Online?
VA Form 22-5495 can be completed digitally and submitted online through VA's GI Bill Benefits website.