RESPONDENT BURDEN: We need this information to determine
your eligibility for education benefits (38 U.S.C. 3513). Title 38
U.S.C. allows us to ask for this information. We estimate that you
will need an average of 45 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
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
SPECIFIC INSTRUCTIONS (Continued)
is 20 years for a surviving spouse if the veteran's death was in
service. Eligibility will terminate in the event a spouse is divorced
from the veteran or in the event a surviving spouse is remarried,
unless the remarriage is both after the surviving spouse's 57th
birthday and after January 1, 2004.
NOTE: A surviving spouse who terminates a remarriage may
re-establish eligibility, but will not qualify for an extension of the
ten-year or twenty-year eligibility period.
ITEM 25. If you received education benefits under a law VA
administers, such as the Montgomery GI Bill Educational Assistance
Program, the Montgomery GI Bill Selected Reserve Educational
Assistance Program, the Reserve Educational Assistance Program,or
Post 9/11 GI Bill, specify which benefit in this block.
ITEM 25C. Check the "Vocational Rehabilitation Benefits" block if
you applied for VA education benefits as a disabled veteran.
ITEM 25E. Check the "Survivors' and Dependents' Educational
Assistance" block if you have previously applied for benefits as the
dependent of a veteran other than the veteran or individual on whose
account you are currently claiming benefits.
ITEM 25F. Check the "None" block if you have never previously
applied for VA education benefits.
ITEM 13G. Check the "Other" block if you previously applied for
VA benefits other than any of those specified in Items 25A through
ITEMS 26 and 27. If you previously applied for VA benefits as the
dependent child or spouse of an individual who is permanently and
totally disabled due to service-connected disabilities or who died on
active duty, provide the name of the individual (your parent or
spouse) and the Social Security Number or the VA file number for
this person in the space provided.
ITEM 30. Benefits under this program are not payable while an
eligible person is serving on active duty in the Armed Forces.
ITEM 32. A child who is under 18 and has not completed high
school must have his or her program of education or training
approved by a VA counselor before educational assistance benefits
can be authorized. An eligible person who has not received a high
school diploma or its equivalent can pursue approved secondary-
level programs. An eligible person can also pursue refresher,
remedial, or deficiency courses needed for admission into an
ITEM 34. If you have ever held a license to practice a profession or
journeyman rating to work at a trade, state the name of the license or
journeyman rating and the state in which the license was held in the
space marked "License or Rating." We only use this information if
you apply for benefits for a similar program. Examples of a license
include the following: electrician, CPA, teacher, lawyer, and
bricklayer. Use Item 36, "Remarks," if you need more space.
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. Services include educational and vocational
guidance and testing to help you to develop a greater understanding
of your skills, talents, and interests. For further information on VA
counseling, call VA Toll Free at:
or TDD 1-800-829-4833
ITEM 35. Your election to receive Survivors' and Dependents'
Educational Assistance is final and cannot be changed. This means
that payments of compensation, pension, or Dependents' Indemnity
Compensation (DIC) based on school attendance after your 18th
birthday are prohibited once you cash your first benefit check under
Page 6 of 7VA FORM 22-5490, JAN 2009
this chapter. If you are planning to pursue a program of education
for longer than 45 months, you may find it to your advantage to
defer benefits and continue compensation, pension, or DIC payment
for the present. If it appears that a deferral of benefits might be to
your advantage, we strongly recommend that you discuss with a VA
counselor the various options open to you. However, if it does not
appear that a referral would be to your advantage, indicate the date
from which you wish to receive Survivors' and Dependents'
ITEM 37. VA publishes Pamphlet 22-73-3, Summary of
Educational Benefits Under the Survivors' and Dependents'
Educational Assistance Program, Chapter 35 of Title 38, U.S.C., an
information pamphlet for this benefit. You should have received
this pamphlet with your application. If you check "YES," VA will
send you one. You may also request a pamphlet from the person
who furnished your this application.
ADVANCE PAYMENT - Once you have enrolled in an approved
course, you may receive an advance payment for the first
month (or part of a month) and second month of enrollment
if ALL the following conditions are met:
You are enrolled on at least a half-time basis, and
Your school has agreed to receive and process
advance payment checks for delivery to it students, and
You request advance payment by signing a request block
on the enrollment certification your school sends to us, and
VA receives your enrollment certification at least 30 days
before classes start
NOTE: If we do not pay an advance payment, we will pay you
after each month you attend school. In some cases, VA will require
you to verify your enrollment each month before you receive
IMPORTANT: Additional requirements set by law may prevent us
from making an advance payment.
HELP: If you need help in completing this application, call VA
TOLL FREE at 1-888-GI-BILL-1 (1-888-442-4551). If you are
hearing impaired, call us toll-free at 1-800-829-4833. Our education
Internet site (www.gibill.va.gov) is available to help you.
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, Code of
Federal Regulations 1.576 for routine uses (i.e., awards of benefits)
as identified in the VA system of records, 58VA21/22,
Compensation, Pension, Education and Rehabilitation Records -
VA, and published in the Federal Register. Your obligation to
respond is required to obtain 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. 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 in
effect prior to January 1, 1975, and still in effect. The requested
information is considered relevant and necessary to determine the
maximum benefits allowable under the law. While you do not have
to respond, VA cannot process your claim for benefits unless the
information is furnished as required by existing law (38 U.S.C.
3513). The responses you submit are considered confidential (38 U.
S.C. 5701). Information submitted is subject to verification through
computer matching programs with other agencies.