VA Form 22-6553d-1: Monthly Certification of On-the-Job and Apprenticeship Training

Fill in the name and facility code of the training facility and the trainee's name and address.

Fill in the VA file number and the payee number.

In Item 2, enter the number of hours trained for each month shown in Item 1 (include any hours of related training given during working hours).

Enter the month(s)/year to be certified.

In Item 3, check YES or NO for the approved program for the month(s) shown in Item 1. If "No," complete Items 4 and 5.

Check the appropriate box, and if training has been terminated, complete Items 4 and 5. If trainee has attained the complete job skills for their job (a "journeyman" knowledge and skills), show this information in Item 5.

Enter the date terminated as MM/DD/YYYY.

Enter the reason for termination.

In Item 6A, check YES or NO for the wage rate in accordance with the training agreement. If "No," complete Items 6B and 6C.

Items 6A, 6B, and 6C: check the appropriate box. If trainee received a wage increase (or decrease) not in accordance with their training agreement, show the new wage rate and the effective date of that wage rate (when trainee first received this wage rate).

Enter the rate in 6B and the effective date (MM/DD/YYYY) in 6C.

Use Item 7, Remarks, to show any additional information concerning a change in the wage rate. Also, if the trainee is receiving additional educational allowance for dependents, use this item to report any change in the number of the trainee's dependents. Also use Item 7 if the trainee's conduct or progress is unsatisfactory.

Enter the printed name and title of the certifying official in 8A and the date signed (MM/DD/YYYY) in 8B.

Sign in ink: the signature of the certifying official.

I CERTIFY THAT the previous statements are true and correct to the best of my knowledge and belief.

Willful false reports concerning benefits payable by VA may result in fines or imprisonment or both.

Please send the completed form to the Regional Processing Office that handles claims for the state in which your training facility is located. Eastern Region: VA Regional Office P.O. Box 4616 Buffalo, NY 14240-4616 serves the following states CO, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD, ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ, NY, OH, PA, RI, SD, TN, VA, VT, WI, WV, WY, APO/FPO, AA, foreign schools, U.S. Virgin Islands 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, SC, TX, UT, WA, APO/FPO, AP, Guam, Philippines, American Samoa, Mariana Islands (VA FORM 22-6553d-1, JAN 2025 Page 2) Return form to VA office address indicated on the back of form.