Va Form 22-5495 - Dependents' Request For Change Of Program Or Place Of Training Page 3
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4INFORMATION AND INSTRUCTIONS FOR COMPLETING THE
DEPENDENTS' REQUEST FOR CHANGE OF PROGRAM OR PLACE OF TRAINING
(VA FORM 22-5495)
Use this form to request a change of program or place of training under the following benefit programs:
• Survivors' and Dependents' Educational Assistance Program (chapter 35 of title 38, U.S. Code)
• Post-9/11 GI Bill Marine Gunnery Sergeant John David Fry Scholarship (chapter 33 of title 38, U.S. Code)
Do not use this form to apply for a change of program or place of training for Veterans' education assistance based on your own service
(chapters 30, 32, 33, 1606, or 1607). To apply for a change of program or place of training for Veterans' education assistance benefits
based on your own service, use VA Form 22-1995, Request for Change of Program or Place of Training.
INTERNET VERSION AVAILABLE- You may complete and submit this application on-line at Click on
"GI Bill: Apply for Benefits."
VA VOCATIONAL AND EDUCATIONAL COUNSELING HELP AVAILABLE- VA offers a wide range of services to assist you
in planning your education and/or career goals. Services include educational and vocational guidance and testing to develop a greater
understanding of your skills, talents, and interests. For more information on VA counseling, call VA toll-free at 1-888-GI-BILL-1
(1-888-442-4551) or if you use the Telecommunications Device for the Deaf (TDD), the Federal Relay number is 711.
NOTE: These numbers on the instructions match the item numbers on the application. Items not mentioned are self-explanatory.
ITEM 3. Your VA FILE NUMBER is the number that appears on your VA benefit checks and all mail that we've sent to you. Generally,
your VA FILE NUMBER is the social security number of the individual on whose account you are receiving benefits. Your SUFFIX
(letter or 2-digit number) indicates your relationship to the qualifying individual.
ITEM 9. The Department of Treasury requires all Federal benefit payments be made by electronic funds transfer (EFT), also called
direct deposit. Please attach a voided personal check or deposit slip or provide the information requested below to enroll in direct deposit.
If you do not have a bank account, you must receive your payment through Direct Express Debit MasterCard. To request a Direct
Express Debit MasterCard you must apply at
or by telephone at 1-800-333-1795. If you elect not to enroll,
you must contact representatives handling waiver requests for the Department of Treasury at 1-888-224-2950. They will address any
questions or concerns you may have and encourage your participation in EFT.
ITEM 17. To qualify for Survivors' and Dependents' Educational Assistance (DEA), you must be either-
(1) The spouse or child of a veteran who is permanently or totally disabled as a result of a service-connected disability.
(2) The spouse or child of an individual on active duty who has been listed as missing in action, captured in line of duty by
hostile force, forcibly detained or interned in line of duty by hostile force, or forcibly detained or interned in line of
duty by a foreign government or power for more than 90 days.
(3) The surviving spouse or child of a veteran who died of a service-connected disability or who dies while a service-connected
disability was rated permanent and total in nature.
(4) The spouse or child of an individual on active duty for which the evidence shows that the individual is hospitalized for
receiving outpatient medical care services or treatment; has a total disability permanent in nature incurred or aggravated in
the line of duty in the active military, naval, or air service; and the serviceperson is likely to be discharged or released
from such service for such disability.
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 became eligible for benefits.) (38 U.S.C. § 103(c)). Additional guidance on when VA recognizes marriages
is available at
Eligibility for DEA will be terminated in the event that VA determines that the individual on whose account benefits are claimed is no
longer totally disabled or VA is notified that the individual is no longer listed as captured, missing in action, or forcibly detained. To
qualify for the Fry Scholarship, you must be the child of an individual who after September 10, 2001, died in the line of duty while
serving on active duty as a member of the Armed Forces.
ITEM 21. Select the benefit under which you are applying for a change in program or place of training. Types of education or training
programs are self-explanatory, except for the following:
"Licensing or Certification Test." A licensing test is a test offered by a state, local, or federal agency that 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. "National
Admissions Exams or National Exams for Credit." Individuals eligible to receive benefits may be reimbursed for the cost of approved test
for admission to or credit at institutions of higher learning.
"Correspondence." Only spouses and surviving spouses eligible for the Survivors' and Dependents' Educational Assistance program and
Fry Scholarship recipients under the Post-9/11 GI Bill may receive benefits for correspondence training. Payments for correspondence
courses are made quarterly after VA receives a certification showing the number of lessons completed. For more information on
correspondence courses, please visit our website at
"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.
VA FORM 22-5495, DEC 2016
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