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

INSTRUCTIONS FOR NOTICE OF CHANGE IN STUDENT STATUS

NOTE: All items not mentioned are considered self-explanatory.

STUDENT COMPLETED TERM BUT NON-PUNITIVE GRADES ASSIGNED
FOR ONE OR MORE COURSES: Check this box if a student completed a term
Item 3 - Enter the VA FILE NUMBER: This is usually the veteran's claim number or
but received non-punitive grades for one or more courses. EXAMPLE: A student
social security number (SSN). If the claimant is receiving CHAPTER 35 benefits, enter completed 12 credits and received "W" grades for 6 credits. Enter the last day of
his or her suffix designation. (designation can be a letter such as A, B, etc. or a number the term in Item 7A. Enter 12 in Item 7C and 6 in 7D.
such as 41, 42, etc.). If the claimant is receiving benefits TRANSFERRED to him or
her, enter the claimant's SSN.
REDUCTION (Non-college Degree Programs) "Non-college Degree Programs":
refers to programs such as diploma or certificate programs that do not lead to a
Item 4A - EDIPI: If known and applicable, enter the claimant's Electronic Data
standard college degree. Check this box if a student reduces his or her course
Interchange Personal Identifier (EDIPI). This is a unique identification number
load in a non-college degree program that is not offered on a term, quarter, or
assigned to a veteran by the Department of Defense (DOD) to confirm their identity.
semester basis. (The program may be offered on a block, unit, or clock basis).
Item 4B - ICN: If known and applicable, enter the claimant's Internal Control Number If the non-degree program is offered on a term, quarter, or semester basis, do not
(ICN). This is a unique identification number assigned by VA to track/process payment check this box. Check the most appropriate of the remaining boxes.
for benefits or services provided.
OTHER: Check this box for any adjustment type not shown and explain in Item
12, REMARKS. EXAMPLES: (a) Incomplete "I" grade(s) not converted to credit
Item 5A and 5B - DATES OF TERM AFFECTED: Enter the begin and end dates for
grade(s) within one calendar year, or (b) Incomplete "I" grade converted to credit
the term or enrollment period in which the change in student status occurred.
grade(s) or to punitive, failing grade(s).
Item 6A- LAST DATE OF ATTENDANCE: Enter the actual last date of
Items 7C and 7D - CREDIT HOURS: Show a breakdown of credit hours as
attendance. For college level courses, you may use one of the following methods to
shown on VA Form 22-1999, Enrollment Certification, if necessary. If the student
determine the last date of attendance: (1) attendance records; (2) grading reports; (3)
is taking noncredit, remedial, deficiency, or independent study courses, show
last date on which examination or other papers filed; (4) last day of activity in the
these hours in addition to the credit hours.
instructor's records; or (5) a statement from the student as to the last day of his or her
attendance.
EXAMPLE:
Item 6B- REASON FOR TERMINATION: (Check the appropriate box).

Before Adjustment

After Adjustment

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.

6 credit hours
+
3 deficiency hours

3 credit hours
+
3 deficiency hours

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 Items 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.
WITHDRAWAL (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 noncollege 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).
If the non-degree program is offered on a term, quarter, or semester basis, check the
most appropriate of the remaining boxes.

Item 8 - CHARGES FOR PERIOD OF ENROLLMENT: When required, report
the student's charges for the ADJUSTED load as if the student began at the
adjusted load.
EXAMPLE: A student starts a term at 12 credits at $1,000 but reduced to 6 credits
in the third week, initially enrolling at 6 credits costs $500. Report $500 in Item
8A.
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. If you report 'Yes', you must retain in your
records the student's statement and/or evidence to substantiate their reason(s) for
being unable to complete a course(s) for receiving a non-punitive grade(s).

OTHER: Check this box for any termination reason not shown and provide an
explanation in Item 12, REMARKS.

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
6C- LEAVE OF ABSENCE (LOA): Enter the appropriate date(s). "Last date attended" occurred. EXAMPLE: A student certified for the entire school year but
is the last date a student attended prior to a LOA and should be reported when a student withdraws during the fall term. If the student is still enrolled for the spring term,
enter that information in Item 12, "Remarks."
begins a LOA. "Resume Date" is the first date attended upon return from a LOA. If a
"Resume Date" is entered a date must also be entered in the Revised Ending Date box, Item 13A - FACILITY CODE: Facility codes contain 8 numbers which identify a
Item 7H. If a student fails to return from a LOA enter the last date the student attended
particular school or training establishment. If you do not know your facility code,
prior to the LOA (i.e., the date entered in C.1 in the "Termination Date" box).
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.
Item 7B - TYPE OF ADJUSTMENT:
INCREASE: Check this box to show an increase in credit hours, clock hours, or high Item 13B - NAME AND ADDRESS OF SCHOOL OR TRAINING
ESTABLISHMENT: Enter the complete name and address of the school or
school units.
training establishment.
REDUCTION DURING DROP PERIOD: Check this box for reductions during an
PRIVACY ACT INFORMATION: VA will not disclose information collected on this form to any
officially designated drop-add period of not more than 30 days.
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,

REDUCTION AFTER DROP PERIOD - NON-PUNITIVE GRADE ASSIGNED: See Compensation, Pension, Education and Veteran Readiness and Employment Records - VA,
published in the Federal Register. Your obligation to respond is required to obtain or retain benefits.
Instruction Item 6B for a definition of "non-punitive." Complete Items 9 & 11.

We cannot pay the student any further education benefits until we receive this information (38 U.S.C

REDUCTION AFTER DROP-ADD PERIOD - PUNITIVE GRADE ASSIGNED: See 3684). Information submitted is subject to verification through computer matching programs with
other agencies.
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
completed 12 credits and received "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.
VA FORM 22-1999b, XXX XXXX

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 2900-0156, and it expires XX/XX/20XX. Public
reporting burden for this collection of information is estimated to average 10 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. 2900-0156 in any
correspondence. Do not send your completed VA Form 22-1990b to this email address.

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OMB Approved No. 2900-0156
Respondent Burden: 10 Minutes
Expiration Date: XX/XX/20XX

NOTICE OF CHANGE IN STUDENT STATUS
2. CURRENT ADDRESS OF STUDENT

1. NAME OF STUDENT (First, Middle, Last)

3. VA FILE NO. (No. could be SSN) (For chapter
35, include suffix) (See instructions, Item 3)

4A. ELECTRONIC DATA INTERCHANGE PERSONAL
IDENTIFIER (EDIPI) (See instructions, Item 4A)

4B. INTERNAL CONTROL NUMBER (ICN)
(See instructions, Item 4B)

5. DATES OF TERM AFFECTED
B. END DATE

A. BEGIN DATE

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

B. REASON FOR TERMINATION
WITHDRAWAL BEFORE BEGINNING OF TERM

GRADUATION / END OF TERM OR COURSE

WITHDRAWAL DURING DROP PERIOD

WITHDRAWAL (Non-college Degree Programs not on term basis- see
Instructions)
LEAVE OF ABSENCE (Must complete appropriate items in 6C and 7H)
(See instructions, item 6C)

WITHDRAWAL AFTER DROP PERIOD - NON-PUNITIVE
GRADES ASSIGNED (If checked, complete Items 9 & 11)
WITHDRAWAL AFTER DROP PERIOD - PUNITIVE
GRADES ASSIGNED
UNSATISFACTORY ATTENDANCE, CONDUCT, OR PROGRESS
2. RESUME DATE
1. LAST DATE ATTENDED

OTHER (Explain in Item 12, Remarks)
3. TERMINATION DATE

C. LEAVE OF ABSENCE
(Complete items 1, 2, 3, and 7H)

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 NON-PUNITIVE GRADES ASSIGNED
FOR ONE OR MORE COURSES

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 12, Remarks)

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

D. CREDIT HOURS AFTER ADJUSTMENT

IN-RESIDENCE

IN-RESIDENCE

FULL TIME

3/4 TIME

DISTANCE

DISTANCE

LESS THAN 1/2 TIME

1/4 TIME OR LESS

F. CLOCK HOURS OR HIGH SCHOOL UNITS BEFORE
ADJUSTMENT
IN-RESIDENCE

G. CLOCK HOURS OR HIGH SCHOOL UNITS AFTER
ADJUSTMENT
IN-RESIDENCE

1/2 TIME

H. REVISED ENDING DATE

DISTANCE

DISTANCE
8. REVISED CHARGES FOR PERIOD OF ENROLLMENT (Complete this item for
chapter 30 students on active duty with an adjusted training load; for ch30/ch35 students
whose training load after adjustment is less than 1/2 time; and all chapter 33 students that
have a change in student status. List the charges for the adjusted load by term or other
period as previously reported)

B. YELLOW RIBBON
(Chapter 33 only)

A. TUITION & FEES

$

$

9. DO PREVIOUS CERTIFICATIONS FOR SUBSEQUENT TERMS REMAIN UNCHANGED?
YES

E. TRAINING TIME/RATE OF PURSUIT AFTER ADJUSTMENT
(For graduate and advanced professional)

NO

10. CALL-UP 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?
NO

YES

UNKNOWN

(If "Yes," you must retain the student's statement and supporting evidence provided in the student's file)

12. REMARKS

IT IS HEREBY CERTIFIED THAT the student's status changed on the date indicated and in accordance with the facts shown above.
13B. SCHOOL OR TRANING ESTABLISHMENT NAME AND ADDRESS

13A. FACILITY CODE

13C. DATE SIGNED

VA FORM
XXX XXXX

13D. PRINTED NAME AND TITLE OF CERTIFYING OFFICIAL

22-1999b

SUPERSEDES VA FORM 22-1999b, JUL 2024
WHICH WILL NOT BE USED.

13E. SIGNATURE OF CERTIFYING OFFICIAL

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