22-1990n Application for Education Benefits Under the National Ca

Application For VA Educational Benefits (VA Forms 22-1990, 22-1990e, 22-1990n)

VBA-22-1990n-ARE (rule) 1

Application for VA Education Benefits

OMB: 2900-0154

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APPLICATION FOR VA EDUCATION BENEFITS UNDER THE
NATIONAL CALL TO SERVICE (NCS) PROGRAM
(VA FORM 22-1990N)

Use this form to apply for education benefits under the National Call to Service (NCS) program (section 510 of title 10, U.S. Code).
You should apply for this benefit if you first entered the military on or after October 1, 2003, signed an enlistment contract with DoD
(Department of Defense) under the NCS program, and you elected one of the two education incentives provided by that program.
INFORMATION AND INSTRUCTIONS
FOR COMPLETING THE APPLICATION FOR VA EDUCATION BENEFITS UNDER THE NCS 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 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 Item 7, and attach either a voided personal check or a deposit slip to match the information in Item 7. 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 8A. 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.
Be sure to do the following:

HOW TO FILE YOUR CLAIM

(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 22-1990N, XXX 20XX

SUPERSEDES VA FORM 22-1990N, MAR 2023,
WHICH WILL NOT BE USED.

Page 1

Eastern Region:
VA Regional Office
P.O. Box 4616
Buffalo, NY 14240-4616
SERVES THE FOLLOWING STATES

DC

DE

IA

IL

IN

KS

KY

MA

ME

MI

MN

MO

MT

NC

ND

NE

NH

NY

OH

PA

RI

SD

TN

VA

VT

WI

CO

CT

MD
NJ
WV

WY

APO / FPO AA

FOREIGN SCHOOLS

US 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

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 Records - VA, published in the Federal Register. Your response 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: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. The OMB control number for this project is 2900-0154, and it expires XX/XX/20XX. Public reporting burden for
this collection of information is estimated to average 15 minutes per respondent, per year, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding
this burden estimate and any other aspect of this collection of information, including suggestions for reducing the burden, to VA Reports Clearance
Officer at VACOPaperworkReduAct@va.gov. Please refer to OMB Control No. 2900-0154 in any correspondence. Do not send your completed VA
Form 22-1990N to this email address.

VA FORM 22-1990N, XXX 20XX

Page 2

OMB Control No. 2900-0154
Respondent Burden: 15 minutes
Expiration Date: XX/XX/20XX

APPLICATION FOR VA EDUCATION BENEFITS UNDER THE
NATIONAL CALL TO SERVICE (NCS) PROGRAM
(Section 510, Title 10, U.S. Code)

INTERNET VERSION AVAILABLE - You may complete and send your application over the Internet at: www.benefits.va.gov/gibill.

PART I - APPLICANT INFORMATION
2. GENDER OF APPLICANT

1. SOCIAL SECURITY NUMBER OF APPLICANT

FEMALE

3. APPLICANT'S DATE OF BIRTH
Month
Day

Year

MALE

4. NAME (First, Middle Initial, Last)

5. APPLICANT'S ADDRESS

Number and Street

Apt./Unit Number

City, State, ZIP Code

6A. APPLICANT'S TELEPHONE NUMBERS (Include Area Code)
Home:

Mobile:

6B. APPLICANT'S E-MAIL ADDRESS (If applicable)

7. 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. See Instructions for additional Direct Deposit information.)

Account Type

Routing or Transit Number
Checking

Account Number

Savings

PART II - TYPE AND PROGRAM OF EDUCATION OR TRAINING

8A. TYPE OF EDUCATION OR TRAINING (See instructions for additional information)
COLLEGE OR OTHER SCHOOL (Including on-line courses)

APPRENTICESHIP OR ON-THE-JOB

VOCATIONAL FLIGHT TRAINING

CORRESPONDENCE

NATIONAL TEST REIMBURSEMENT (SAT, CLEP, ETC.)
LICENSING OR CERTIFICATION TEST REIMBURSEMENT
(MCSE, CCNA, EMT, NCLEX, ETC.)
8B. FULL NAME AND ADDRESS OF SCHOOL, IF KNOWN

VA DATE STAMP
(Do Not Write In This Space)

8C. PLEASE SPECIFY YOUR EDUCATIONAL OR CAREER OBJECTIVE, IF KNOWN (e.g. Bachelor of Arts in Accounting,
welding certificate, police officer, etc.)

(Check, if applicable)
If during the review made by VA I am found to be eligible for more than one benefit,
I authorize VA to pay the benefit with the highest monthly rate.
VA FORM
XXX 20XX

22-1990N

SUPERSEDES VA FORM 22-1990N, MAR 2023,
WHICH WILL NOT BE USED.

Page 3

SOCIAL SECURITY NUMBER OF APPLICANT

PART III - SERVICE INFORMATION
NOTE: It will help VA process your claim if you send the following:
DD 2863 (National Call to Service (NCS) Election of Options)
DD Form 214 (Member 4) for all periods of active duty service
9A. ARE YOU NOW ON ACTIVE DUTY?
YES

NO

9B. ARE YOU NOW ON TERMINAL LEAVE JUST BEFORE DISCHARGE?
YES

NO

(If "Yes," please provide a copy of your DD Form 214 (Member 4) when issued)
10. PLEASE COMPLETE THE FOLLOWING FOR EACH PERIOD OF MILITARY SERVICE

A. DATE ENTERED

B. DATE SEPARATED

C. SERVICE COMPONENT (USN, USAF,
USAR, ARNG, ETC.)

D. SERVICE STATUS (Active duty, drilling reservist,
IRR, etc.)

PART IV - ENTITLEMENT TO AND USAGE OF ADDITIONAL TYPES OF ASSISTANCE
11A. ARE YOU CURRENTLY PARTICIPATING IN A SENIOR ROTC SCHOLARSHIP PROGRAM
WHICH PAYS FOR YOUR TUITION, FEES, BOOKS AND SUPPLIES UNDER SECTION 2107,
TITLE 10, U.S. CODE?

YES

11B. FOR ACTIVE DUTY CLAIMANTS ONLY: 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 the VA for education
benefits? If you receive such benefits during any part of your training, check "YES."
11C. FOR CIVILIAN EMPLOYEES OF THE U.S. GOVERNMENT ONLY: Do you expect to receive
funds from your agency or department for the same course(s) for which you expect to receive VA
education assistance? (If "Yes, " show the source of these funds.)

NO

YES

NO

YES

NO

APPLICATION SUBMISSION REMINDERS
Did you remember to .......
• Write your complete mailing address and email address?
• Attach a copy of DD 2863 (National Call to Service (NCS) Election of Options)
IF SO, PLEASE SIGN AND DATE THE APPLICATION BELOW

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.
12A. SIGNATURE OF APPLICANT (DO NOT PRINT)

VA FORM 22-1990N, XXX 20XX

12B. DATE SIGNED

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File Typeapplication/pdf
File Title22-1990n
SubjectAPPLICATION FOR V. A. EDUCATION BENEFITS UNDER THE .NATIONAL CALL TO SERVICE (N C S) PROGRAM .(Section 510, Title 10, U.S. Code)
File Modified2024-10-23
File Created2024-10-23

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