Va Form Change PDF Details

Do you need to fill out paperwork for a disability claim or medical procedure? Are you having trouble navigating the VA’s array of forms, instructions and terms of service? If so, you're not alone. The VA has recently released an updated form that makes filing easier and more efficient. In this blog post, we'll explore how recent updates to the VA Form make it simpler than ever before to file your disability or medical benefits claim. We'll go into step-by-step detail on completing your application accurately and quickly so that you can receive the care and assistance you need without all the hassle. So, let's get started!

Question	Answer
Form Name	Va Form Change
Form Length	4 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min
Other names	vba 22 1995 are va 1995 2015 form

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OMB Control No. 2900-0074

Respondent Burden: 20 Minutes

Expiration Date: 08/31/2024

REQUEST FOR CHANGE OF PROGRAM OR PLACE OF TRAINING

PART I - IDENTIFICATION AND PERSONAL INFORMATION

1A. NAME OF APPLICANT (Last, First, Middle)

VA DATE STAMP

DO NOT WRITE IN THIS SPACE

1B. MAILING ADDRESS (Complete street address, City, State, and 9-digit ZIP Code)

1C. APPLICANT'S TELEPHONE NUMBER (Including Area Code)

1D. VA FILE NUMBER

HOME (include area code)

MOBILE (include area code)

1F. SOCIAL SECURITY OF APPLICANT (For transferability cases,

1E. APPLICANT'S E-MAIL ADDRESS (if applicable)

enter the veteran's social security number)

PART II - YOUR PROGRAM INFORMATION

2. EDUCATION BENEFIT YOU WANT TO RECEIVE (Only Select One)

CHAPTER 33 (Post-9/11 GI BILL)

CHAPTER 32 (Veterans Educational Assistance

TRANSFER OF ENTITLEMENT PROGRAM

Program including section 903)

CHAPTER 30 (Montgomery GI Bill -

CHAPTER 1606 (Montgomery GI Bill-

Active Duty)

Selected Reserve)

3. HOW WILL YOU TAKE TRAINING?

SCHOOL ATTENDANCE

LICENSING & CERTIFICATION TEST

COOPERATIVE TRAINING

NATIONAL ADMISSIONS EXAMS OR

CORRESPONDENCE

TUITION ASSISTANCE TOP-UP

(Active Duty Only)

NATIONAL EXAMS FOR CREDIT

APPRENTICESHIP OR ON-THE-JOB

FLIGHT TRAINING

TRAINING

4A. WHAT EDUCATIONAL, PROFESSIONAL OR VOCATIONAL GOAL ARE

4B. WHAT IS THE NAME OF THE PROGRAM YOU ARE REQUESTING?

YOU WORKING TOWARD?

4C. IF CHANGING SCHOOLS, PROVIDE NAME AND COMPLETE ADDRESS

4D. PROVIDE NAME AND COMPLETE ADDRESS OF PREVIOUS SCHOOL OR

OF NEW SCHOOL OR TRAINING ESTABLISHMENT YOU ARE PLANNING

TRAINING ESTABLISHMENT (If only changing schools, list current school.)

TO ATTEND (If applicable)

4E. TELL US WHEN AND WHY YOU STOPPED TRAINING AT YOUR PRIOR SCHOOL OR ESTABLISHMENT. CONTINUE IN REMARKS, ITEM 10, OR ON A SEPARATE

SHEET IF NECESSARY. (If applicable)

VA FORM

22-1995

SUPERSEDES VA FORM 22-1995, JUL 2020,

Page 1

JUL 2021

WHICH WILL NOT BE USED.

PART III - DIRECT DEPOSIT INFORMATION

5A. DIRECT DEPOSIT (To enroll in Direct Deposit, attach a voided personal check or deposit slip to match the information provided below. Direct Deposit is not available for Chapter 32 recipients.)

NOTE: To prevent possible delays in payment, claimants are highly encouraged to use Direct Deposit and set up an Electronic Fund Transfer (EFT.) Direct Deposit is not available for the Post-Vietnam Era Educational Assistance Program (VEAP - Chapter 32) nor for Section 903. See Instructions, Item 5 for additional Direct Deposit Information.)

5B. START OR CHANGE EFT

STOP EFT

5C. 9 DIGIT ROUTING OR TRANSIT NUMBER	ACCOUNT TYPE		ACCOUNT NUMBER
	CHECKING	SAVINGS
	CHECKING	SAVINGS



5D. NAME OF FINANCIAL INSTITUTION

PART IV - MISCELLANEOUS INFORMATION

6.INFORMATION ON DEPENDENTS (COMPLETE THIS ITEM ONLY IF YOU SERVED BEFORE JANUARY 1, 1977 (or had a delayed entry before January 2, 1978) AND YOU CURRENTLY HAVE DEPENDENTS.)

QUESTIONS

YES

6A. ARE YOU CURRENTLY MARRIED?

6B. DO YOU HAVE ANY CHILDREN WHO ARE:

(1) UNDER AGE 18 OR

(2) OVER 18 BUT UNDER AGE 23, NOT MARRIED AND ATTENDING SCHOOL? OR

(3) OF ANY AGE PERMANENTLY HELPLESS FOR MENTAL OR PHYSICAL REASONS?

6C. IS EITHER YOUR FATHER OR MOTHER DEPENDENT UPON YOU FOR FINANCIAL SUPPORT?

7.RECENT PERIODS OF SERVICE (PERIODS OF ACTIVE DUTY SINCE YOUR INITIAL PERIOD OF ACTIVE DUTY.) Please complete this section for each period of your active duty since your initial period of active duty if you have not previously reported this information. It will help VA process your claim if you attach a certified copy of "Member 4 Copy" of your DD Form 214 for each period of active service. (Don't report Active Duty for Training.)

7A. BRANCH OF SERVICE AND RESERVE OR GUARD COMPONENT SERVED IN DURING ACTIVE DUTY

7B. BEGINNING AND ENDING

DATES OF ACTIVE DUTY

7C. WERE YOU

INVOLUNTARILY CALLED TO

ACTIVE DUTY FOR THIS PERIOD? (If yes send in

copies of your orders)

YES			NO

7D. WHAT WAS THE CHARACTER

OF YOUR DISCHARGE?

7E. IF THIS ACTIVE DUTY IS

NATIONAL GUARD DUTY, INDICATE

IF AUTHORITY IS TITLE 10

(FEDERAL) OR TITLE 32 (STATE).

(ATTACH COPIES OF ANY ORDERS)

NOTE: DO NOT INCLUDE FULL TIME ASSIGNMENT BY A SERVICE DEPARTMENT TO A CIVILIAN SCHOOL FOR A COURSE OF EDUCATION; ATTENDANCE AT A SERVICE ACADEMY; OR NON-CREDITABLE TIME (TIME LOST BECAUSE OF INDUSTRIAL OR AGRICULTURAL FURLOUGH, ARREST WITHOUT ACQUITTAL, BEING AWOL, DESERTION, SENTENCE OF COURT-MARTIAL, ETC.)

8.DO YOU EXPECT TO RECEIVE EDUCATIONAL BENEFITS UNDER THE GOVERNMENT EMPLOYEE'S TRAINING ACT (GETA) FOR THE SAME COURSE(S) YOU WILL RECEIVE VA EDUCATION BENEFITS? (Answer only if you are a Federal Government employee)

YES

9.ARE YOU RECEIVING OR DO YOU ANTICIPATE RECEIVING ANY MONEY (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 VA FOR EDUCATION BENEFITS? IF YOU WILL RECEIVE SUCH BENEFITS, CHECK "YES." SHOW COMPLETE DETAILS IN THE REMARKS SECTION TO INCLUDE THE SOURCE OF THE FUNDS. NOTE: IF YOU ARE APPLYING FOR THE TUITION ASSISTANCE TOP-UP BENEFIT, CHECK "NO." (Answer only if you are on Active Duty)

YES

10. REMARKS

PART V - 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.

11A. SIGNATURE OF APPLICANT (DO NOT PRINT)

SIGN HERE IN INK

11B. DATE SIGNED

VA FORM 22-1995, JUL 2021	Page 2

INSTRUCTIONS & INFORMATION

When Should You Use This Form?

Use this form when:

•you're changing schools,

•you're changing your educational, professional, vocational goal,

•you left your program due to unsatisfactory attendance, progress, or conduct; and you're now reentering the same program,

•you were receiving VA education benefits as a veteran and now wish to receive benefits while on active military duty.

INSTRUCTIONS FOR SPECIFIC ITEMS ON THE FORM

Most items on this form are self-explanatory. Here is additional information on certain items.

Item #4A: Here are some examples of what we mean by "goals":

•Educational goal: GED certificate, high school diploma, bachelor's degree, master's degree, Ph.D

•Professional goal: lawyer, physician, teacher, physical therapist, medical technologist, medical records librarian, stenographer, machinist, electronic technician, X-ray technician, radio and

•Vocational goal: TV service technician, automobile mechanic, practical nurse.

Items 5A through 5D: The Department of the Treasury requires all Federal benefit payments be made by electronic funds transfer (EFT), also called direct deposit (Direct Deposit is not available for Chapter 32 recipients). To enroll in direct deposit, provide the information requested in Items 5A through 5D and attach either a voided personal check or a deposit slip to match the information in Items 5A through 5D. If you do not have a bank account, please visit https://www.benefits.va.gov/benefits.banking.asp. This website provides information about the Veterans Benefits Banking Program (VBBP), and a link to banks and credit unions that may fit your needs. You may also call 1-800-827-1000. If you elect not to enroll, you must contact representatives handling waiver requests for the Department of the Treasury at 1-888-224-2950. They will encourage your participation in EFT and address any questions or concerns you may have.

Item #6: Provide your dependents' information only if you have military service before January 1, 1977 (or delayed entry before January 2, 1978).

Item #6A: IMPORTANT: If you are certifying that you are married for the purpose of VA benefits, your marriage must be recognized by the place where you and/or your spouse resided at the time of marriage, or where you and/or your spouse resided when you filed your claim (or a later date when you become eligible for benefits) (38 U.S.C. § 103(c)). Additional guidance on when VA recognizes marriages is available at http://www.va. gov/opa/marriage/.

If You Need Help

If you need help in completing this form, you can contact us through our home page on the Internet. Our website is: www.benefits.va.gov/gibill. Click on the "Contact Us" tab and then the "Ask a Question" tab. Or you may call us 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. Please call 1-800-827-1000 if you want a VA counselor to help you in planning your program.

TO FILE THIS FORM:

(A) If you have selected a school or training establishment,

Step1: Mail the completed form to the VA Regional Processing Office in the region of that school's or establishment's physical address. Determine the correct office from the list on page 4.

Step 2: Notify the veterans certifying official at your school or training establishment that you have applied for VA education benefits. Ask him or her to submit 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 our decision concerning your continued eligibility for educational assistance.

(B)If you have not selected a school or training establishment,

Step 1: Mail the completed form to the VA Regional Processing Office in the region of your home address. Determine the correct office from the list on page 4.

Step 2: Wait for VA to process your application and notify you of our decision concerning your continued eligibility for educational assistance.

VA FORM 22-1995, JUL 2021	Page 3

Eastern Region:

VA Regional Office

P. O. Box 4616

Buffalo, NY 14240-4616

SERVES THE FOLLOWING STATES

APO/FPO AA

FOREIGN

U.S. VIRGIN ISLANDS

SCHOOLS

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

REQUEST TO OPT OUT OF INFORMATION SHARING WITH EDUCATIONAL INSTITUTIONS:

The Harry W. Colmery Veterans Educational Assistance Act of 2017 (Public Law 115-48), also known as the "Forever GI Bill," requires the Department of Veterans Affairs (VA) to make available to educational institutions information about the amount of educational assistance to which a Veteran or other eligible individual is entitled. If you're eligible for the Post-9/11 GI Bill (Chapter 33), Montgomery GI Bill - Active Duty (Chapter 30), Montgomery GI Bill -Selected Reserve, (Chapter 1606), or the Survivors' and Dependents' Educational Assistance Program (DEA) (Chapter 35), you may elect to “opt-out” of these disclosures and have VA withhold this information instead. To request an opt-out, or for information about how to opt- out, please refer to our website at va.gov, or click https://www.va.gov/find-forms/, to complete the Request to Opt-Out of Information Sharing with Educational Institutions, VA Form 22-0993.

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 1.526 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 Veteran Readiness and Employment Services - VA, published in the Federal Register. Your obligation to respond is required to obtain or retain education benefits. 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 continued eligibility to VA 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 20 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 1-888-GI-BILL-1 (1-888-442-4551) to get information on where to send comments or suggestions about this form.

VA FORM 22-1995, JUL 2021

Page 4

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1. Begin completing the Va Form Change with a selection of major blanks. Gather all the necessary information and make sure there's nothing overlooked!

2. Just after finishing the last step, go to the subsequent stage and fill in the essential details in these blank fields - CORRESPONDENCE, APPRENTICESHIP OR ONTHEJOB TRAINING, TUITION ASSISTANCE TOPUP Active, FLIGHT TRAINING, NATIONAL ADMISSIONS EXAMS OR, A WHAT EDUCATIONAL PROFESSIONAL OR, B WHAT IS THE NAME OF THE PROGRAM, C IF CHANGING SCHOOLS PROVIDE NAME, D PROVIDE NAME AND COMPLETE, and E TELL US WHEN AND WHY YOU STOPPED.

Va Form Change writing process detailed (part 2)

3. Completing A DIRECT DEPOSIT To enroll in, B START OR CHANGE EFT, STOP EFT, C DIGIT ROUTING OR TRANSIT NUMBER, ACCOUNT TYPE, ACCOUNT NUMBER, D NAME OF FINANCIAL INSTITUTION, CHECKING, SAVINGS, INFORMATION ON DEPENDENTS, QUESTIONS, YES, PART IV MISCELLANEOUS INFORMATION, A ARE YOU CURRENTLY MARRIED, and B DO YOU HAVE ANY CHILDREN WHO ARE is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

D NAME OF FINANCIAL INSTITUTION, A DIRECT DEPOSIT To enroll in, and SAVINGS of Va Form Change

4. You're ready to fill out the next segment! Here you'll get all these YES, NOTE DO NOT INCLUDE FULL TIME, DO YOU EXPECT TO RECEIVE, WILL RECEIVE VA EDUCATION BENEFITS, YES, ARE YOU RECEIVING OR DO YOU, YES, REMARKS, PART V CERTIFICATION AND, I CERTIFY THAT all statements in, and PENALTY Willful false statements empty form fields to do.

5. When you near the conclusion of this file, you'll find several extra points to complete. Specifically, PENALTY Willful false statements, A SIGNATURE OF APPLICANT DO NOT, B DATE SIGNED, SIGN HERE IN INK, VA FORM JUL, and Page must be filled out.

It's very easy to make an error while filling out the SIGN HERE IN INK, consequently you'll want to go through it again before you finalize the form.

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