Form VA Form 22-1999b VA Form 22-1999b Notice of Change in Student Status

Notice of Change in Student Status (22-1999b)

22-1999b(11-14)

Notice of Change in Student Status

OMB: 2900-0156

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 2900-0156 can be found here:

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INSTRUCTIONS FOR NOTICE OF CHANGE IN STUDENT STATUS
NOTE: All items not mentioned are considered self-explanatory.
Item 2 - Enter the VA FILE NUMBER: This is usually the veteran's claim
number or social security number.
Item 2 - If the claimant is receiving CHAPTER 35 benefits, enter his or her
suffix. (This is a letter (A, B, etc.) designation.) For transferability cases, enter
the veteran's social security number.
Item 4 - If the claimant is receiving benefits transferred to him or her, enter the
claimant's SOCIAL SECURITY NUMBER.
Item 5 - DATES OF TERM AFFECTED: Enter the begin and end dates for the
term in which the change in student status occurred.
Item 6A - LAST DATE OF ATTENDANCE: Enter the actual last date of
attendance. For college level courses, you may use one of the following methods
to determine the last date of attendance: (1) attendance records; (2) grading
reports; (3) last date on which examination or other papers filed; (4) last day of
activity in the instructor's records; or (5) a statement from the student as to the
last day of his or her attendance
Item 6B - REASON FOR TERMINATION: (Check the appropriate box.)
WITHDRAWAL DURING DROP PERIOD: Check this box for withdrawals
during an officially designated drop period of not more than 30 days. Do not
use this box for withdrawals after the drop period of more than 30 days after the
start of the term, whichever is earlier.
WITHDRAWAL AFTER DROP PERIOD - NON PUNITIVE GRADE
ASSIGNED: A non punitive grade is any grade not used to compute graduation
requirements. A non punitive grade is the equivalent of an audited course for
purposes of advancement toward graduation.
Typical examples are
"W" (withdrawal) and "NC" (no credit). Complete Item 9 & 11.
WITHDRAWAL AFTER DROP PERIOD - PUNITIVE GRADE ASSIGNED:
A punitive grade is one assigned a value when computing graduation
requirements. A common example is an "F" (failing) grade which has a quality
point value of "zero."
UNSATISFACTORY ATTENDANCE, CONDUCT, OR PROGRESS: Check
this box for failure to meet the school's standards of attendance, conduct, or
progress. In Item 6A, show the last date attendance, conduct, or progress was
satisfactory.
OTHER (Explain in Item 12, Remarks): Check this box for any termination
reason not shown.
WITHDRAWAL OR INTERRUPTION (Non College Degree Programs
(NCD)): "Non College Degree Programs" refers to programs such as diploma or
certificate programs that do not lead to a standard college degree. Check this box
if a student terminates or interrupts a non college degree program that is not
offered on a term, quarter, or semester basis. (The program may be offered
on a block, unit, or clock basis.) For such programs, report in Item 12,
Remarks, the first date from which no credit accrued toward graduation.
If the non degree program is offered on a term, quarter, or semester basis, check
the most appropriate of the remaining boxes.
Item 6C - LAST DATE CREDIT ACCRUED (For NCD Only): For NCD
programs operating on a block, unit, or clock basis, enter the last date the student
accrued credit toward graduation.
Item 7B - TYPE OF ADJUSTMENT:
INCREASE: Check this box to show an increase in credit hours, clock hours,
or high school units.
REDUCTION DURING DROP PERIOD: Check this box for reductions during
an officially designated drop-add period of not more than 30 days.
REDUCTION AFTER DROP PERIOD - NON PUNITIVE GRADE
ASSIGNED: See Instructions Item 6B for the definition of "non punitive."
Complete Items 9 & 11.

REDUCTION AFTER DROP-ADD PERIOD - PUNITIVE GRADE ASSIGNED:
See Instructions, Item 6B for a definition of "punitive."
STUDENT COMPLETED TERM BUT NON PUNITIVE GRADES ASSIGNED
FOR ONE OR MORE COURSES: Check this box if a student completed a term but
received non punitive grades for one or more courses. EXAMPLE: A student
completes 12 credits and receives "W" grades for 6 credits. Enter the last day of the
term in Item 7A. Enter 12 in Item 7C and 6 in Item 7D.
REDUCTION (Non College Degree Programs) "Non College Degree Programs":
refers to programs such as diploma or certificate programs that do not lead to a
standard college degree. Check this box if a student reduces his or her course load in
a non college degree program that is not offered on a term, quarter, or semester
basis. (The program may be offered on a block, unit, or clock basis.) For such
programs, report in Item 12, Remarks, the first date from which no credit accrued
toward graduation.
If the non degree program is offered on a term, quarter, or semester basis, do not
check this box. Check the most appropriate of the remaining
boxes.
OTHER (Explain in Item 12 Remarks): Check this box for any adjustment type not
shown. EXAMPLES: (a) Incomplete "I" grade(s) not converted to credit grade(s)
within one calendar year, or (b) Incomplete "I" grade converted to credit grade(s) or
to punitive, failing grade(s).
Items 7C and 7D - CREDIT HOURS: Show a breakdown of credit hours as shown
on VA Form 22-1999, Enrollment Certification, if necessary. If the student is taking
noncredit, remedial, deficiency, or independent study courses, show these hours in
addition to the credit hours.
EXAMPLE:
Before Adjustment

After Adjustment

6 credit hours
+
3 deficiency hours

3 credit hours
+
3 deficiency hours

Item 8 - CHARGES FOR PERIOD OF ENROLLMENT: When required report the
customer charges for the ADJUSTED load only. EXAMPLE: A student starts a term
at full time, but reduces to less than half-time in the third week.
Item 9 - PREVIOUS CERTIFICATIONS FOR SUBSEQUENT TERMS: Check
"yes" if there are terms, previously certified, which follow the term of the
termination or adjustment and are not affected by the termination or adjustment.
Check "no" if there are terms, previously certified, which follow the term of the
termination or adjustment and are no longer valid.
Item 10 - CALL-UP TO ACTIVE DUTY: If the termination or adjustment occurs
because the student has been called to active duty, please indicate whether credit has
been granted for interrupted coursework by checking the appropriate box.
Item 11 - MITIGATING CIRCUMSTANCES: These are unavoidable or
unexpected events that directly interfere with a student's pursuit of a course and are
beyond the student's control. Students must submit corroborative evidence to
substantiate their reasons for being unable to complete a course or courses, or
receiving a non punitive grade.
Item 12 - REMARKS: Use this space to provide any needed clarification. It is
important to clarify the student's status for terms after the one in which a change
occurred. EXAMPLE: A student certified for the entire school year withdraws
during the fall term. If the student is still enrolled for the spring term, enter that
information in Item 12, "Remarks."
Item 13C - NAME AND ADDRESS OF SCHOOL OR TRAINING
ESTABLISHMENT (Include facility code): Enter the complete name and address of
the school or training establishment and the facility code. Facility codes contain 8
numbers which identify a particular school or training establishment. If you do not
know your facility code, contact the VA Education Liaison Representative. Entering
the facility code will help VA to be sure that your school is properly shown in the
student's record.

PRIVACY ACT INFORMATION: 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 CFR 1.576 for routine
uses (i.e., award of benefits) 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 benefits. We cannot pay the student any further education benefits until we receive this information (38 U.S.C 3684). Information submitted is
subject to verification through computer matching programs with other agencies.
RESPONDENT BURDEN: We need this information to determine whether educational benefits should be increased, decreased, or terminated, and if so, the effective date of such change (38 U.S.C. 3034(a),
3241, 3474, 3524, 3680(a), and 10 U.S.C. 510, 1636(b), and chapter 1607). Title 38, U.S.C., allows us to ask for this information. 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 Intenet Page at www.reginfo.gov/public/do/PRAMain. If desired, you can call 1-888-GIBILL-1 (1-888-442-4551), (Telecommunications Device for the Deaf (TDD), Federal Relay number is 711), to get information on where to send your comments or suggestions about this form.

VA FORM 22-1999b, XXX 2014

OMB Approved No. 2900-0156
Respondent Burden: 10 Minutes
Expiration Date: XX/XX/XXXX

NOTICE OF CHANGE IN STUDENT STATUS
1. NAME OF STUDENT (First, Middle, Last)

2. VA FILE NO. (For chapter 35, include suffix. For transferability cases,
enter the veteran's Social Security Number)

3. CURRENT ADDRESS OF STUDENT

4. SOCIAL SECURITY NO. OF APPLICANT (If not entered in Item 2)

5. DATES OF TERM AFFECTED
A. BEGIN DATE

B. END DATE

5. TERMINATION (Complete Items A and B, and C if applicable)
A. LAST DATE OF
ATTENDANCE

B. REASON FOR TERMINATION

END OF TERM OR COURSE

WITHDRAWAL BEFORE BEGINNING OF TERM

UNSATISFACTORY ATTENDANCE, CONDUCT, OR PROGRESS

WITHDRAWAL DURING DROP PERIOD

GRADUATION

WITHDRAWAL AFTER DROP PERIOD - NONPUNITIVE
GRADES ASSIGNED (If checked, complete Items 9 & 11)

WITHDRAWAL OR INTERRUPTION (Non college Degree Programs
not on term basis- see Instructions)

WITHDRAWAL AFTER DROP PERIOD - PUNITIVE
GRADES ASSIGNED
C. LAST DATE CREDIT ACCRUED (For non-college degree courses only)

OTHER (Explain in Item 12, Remarks)

7. ADJUSTMENT OF CREDIT OR CLOCK HOURS (Complete Items A, B, and C thru H as applicable)
A. DATE ADJUSTMENT
IS EFFECTIVE

B. TYPE OF ADJUSTMENT
INCREASE

REDUCTION AFTER DROP PERIOD - PUNITIVE GRADES ASSIGNED

INCREASE ON FIRST DAY OF TERM

STUDENT COMPLETED TERM, BUT NONPUNITIVE GRADES ASSIGNED
FOR ONE OR MORE COURSES (If checked, complete Item 8)

REDUCTION ON FIRST DAY OF TERM

REDUCTION (Non college Degree Programs not on term basis- see Instructions)

REDUCTION DURING DROP PERIOD

OTHER (Explain in Item 9, Remarks)

REDUCTION AFTER DROP PERIOD - NONPUNITIVE
GRADES ASSIGNED (If checked, complete Item 9 & 11)
C. CREDIT HOURS BEFORE ADJUSTMENT

D. CREDIT HOURS AFTER ADJUSTMENT

F. CLOCK HOURS OR HIGH SCHOOL UNITS BEFORE
ADJUSTMENT

3/4 TIME

LESS THAN 1/2 TIME

1/4 TIME OR LESS

H. REVISED ENDING DATE

A. TUITION

B. FEES

C. YELLOW RIBBON
(Chapter 33 only)

9. DO PREVIOUS CERTIFICATIONS FOR SUBSEQUENT TERMS REMAIN UNCHANGED?
NO

1/2 TIME

FULL TIME
G. CLOCK HOURS OR HIGH SCHOOL UNITS AFTER
ADJUSTMENT

8. CHARGES FOR PERIOD OF ENROLLMENT (Complete this item for in-service
students, student's whose training load after adjustment is less than 1/2 time and all chapter 33
students that have a change in status. List the charges for the adjusted load by school year,
term, or other period. This item does not apply to students receiving chapter 32 or 1606
benefits).

YES

E. TRAINING TIME AFTER ADJUSTMENT (For graduate and advanced
professional)

10. CALLUP TO ACTIVE DUTY (Complete if student called to
active duty- see Instructions)
STUDENT CALLED UP - No Credit Granted
STUDENT CALLED UP - Credit Granted

MITIGATING CIRCUMSTANCES (Complete only if indicated by Item 6 or 7)
11. DOES THE STUDENT CLAIM THAT TERMINATION OR ADJUSTMENT ACTIONS INVOLVED MITIGATING CIRCUMSTANCES?
YES

UNKNOWN

(If "Yes," attach student's statement together with the student's supporting evidence)

12. REMARKS

IT IS HEREBY CERTIFIED THAT the student's status changed on the date indicated and in accordance with the facts shown above.
13A. DATE

VA FORM
XXX 2014

13B. SIGNATURE AND TITLE OF CERTIFYING OFFICIAL

22-1999b

13C. NAME AND ADDRESS OF SCHOOL OR TRAINING ESTABLISHMENT
(Include Facility Code)

SUPERSEDES VA FORM 22-1999b, JUL 2012,
WHICH WILL NOT BE USED.

VA Copy 1