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Va Form 22-1999c - Certificate Of Affirmation Of Enrollment Agreement Correspondence Course Page 2

Privacy Act Notice: 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 as identified in the VA system of records,

58VA21/22/28, Compensation, Pension, Education, and Vocational Rehabilitation Records - VA, published in the Federal Register. An

example of a routine use allows VA to send 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 VA to obtain further information as may be

necessary from the school for VA to properly process the veteran's education claim or to monitor his or her progress during training.

Your obligation to respond is required to obtain or retain benefits. We cannot pay you any education benefits for taking a correspondence

course until we receive this information (38 U.S.C. 3686(b)). Your responses are 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: We need this information to determine your eligibility for education benefits based on a correspondence course

and the proper amount payable for that correspondence course. Title 38, United States Code, allows us to ask for this information. We

estimate that you will need an average of 3 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 call1-888-GI-BILL-1 (1-800-442-4551) to get information on where to send

comments or suggestions about this form.

VA FORM 22-1999c, NOV 2008

Va Form 22-1999c - Certificate Of Affirmation Of Enrollment Agreement Correspondence Course Page 2