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WHAT ARE THE BENEFITS?

Waiver of all mandatory system wide tuition and fees at any State of California Community College, Campus of the University of California, or Campus of

the California State University system.

WHO MAY APPLY?

1 - Students must meet the California residency requirements as determined by the school they will attend.

AND

2 - Students who meet the requirements of at least one of the following plans

PLAN A:

The spouse, unmarried child, or unmarried surviving spouse or California certified registered domestic partner (RDP) of a

veteran who is totally service-connected disabled or who has died of service-related causes, may qualify. The veteran must

have served during a period of war declared by Congress, or been awarded a Campaign or Expeditionary Medal. This program

does not have an income limit. A child must be under 27 years of age to receive the fee waiver benefit. The age limit is

extended to 30 years of age if the child is a veteran. There are no age limits for a spouse, surviving spouse or RDP. *Note: a

dependent cannot receive this benefit if they are in receipt of VA Chapter 35 benefits.

OR,

PLAN B:

The child (no age limit) of a veteran who has a service-connected disability, or had a service-connected disability at the time of

death, or who died of service-related causes, may also qualify for a waiver of fees. The child’s income, which includes the

student’s ADJUSTED GROSS INCOME, PLUS THE VALUE OF SUPPORT provided by a parent, cannot exceed the

“national poverty level” as published by the U.S. Census Bureau on December 31

of last year. *NOTE: This figure changes

annually. To obtain the applicable national poverty level, contact your local County Veterans Service Office (CVSO). In cases

where the DVS 40 reports $0 AGI & $0 Value of Support, a certified statement must be completed which states how the

student can afford to attend school.

PLAN C:

Any dependent, non-remarried surviving spouse, or current RDP of a member of the California National Guard who was

killed, permanently disabled or died of this disability that resulted from activation under Military and Veterans Code Section

146.

OR,

PLAN D:

Available to Medal of Honor (also known as Congressional Medal of Honor) recipients and their children.

HOW TO APPLY:

(1) This form must be fully completed and signed by the student and the veteran (or parent, but you must explain why the veteran is not available). Provide

valid photo ID for student and veteran/parent. Form must be completely filled out. If a question does not apply, write "N/A”. If neither parent is available

to sign, please attach an explanation.

(2) A child, under PLAN B, must submit either a copy of their federal income tax form 1040 or state income tax form 540, from "Last Year" or, if a child does not

have a copy of their income tax, or if a child did not file a return, they must submit a statement from the Internal Revenue Service (800-829-1040) or the Franchise

Tax Board (800-852-5711) which must verify the amount of adjusted gross income or the fact that a return was not filed. **NOTE**: Current academic year

entitlement is based upon last year’s adjusted gross income and value of support. For Example: If applying for benefits for academic year 2016-2017, the total

amount of your reported adjusted gross income and value of support from calendar year 2015 will be used to determine eligibility.

(3) If you are a child of a veteran, you must attach a Verification of Dependency. Acceptable verifications include, but are not limited to, a Birth

Certificate, Adoption Records, and Marriage Certificate. Those seeking status as an Adopted Child or as a Stepchild must have entered into such status

prior to the child’s 24

birthday.

WHEN TO APPLY:

Always try to apply for these benefits prior to attending school. Benefits are awarded on an academic year basis and students are required to reapply each year for

ongoing benefits. NOTE: The earliest effective date fee waiver benefits may be awarded is the first day of the academic year in which an application is received.

WHERE TO APPLY:

To obtain an application, additional information and to apply for benefits under this program, contact your local County Veterans Service Office at:

If eligibility criteria are met, use of the California College Fee Waiver for Veterans Dependents may be applied to state-supported programs in the CCC, CSU, and

UC systems. Some academic programs at these institutions that are considered self-supported, commonly referred to as extension courses or extended education

are not covered under the Fee Waiver because these courses, degrees, and certificates are neither funded by the state nor are they system-wide programs. Veteran

dependents applying for this waiver should research their academic programs thoroughly before applying to the college or university.

TO LEARN MORE ABOUT THE BENEFITS YOU HAVE EARNED, VISIT:

PRIVACY NOTIFICATION

The Information Practices Act of 1977 (Civil Code Section 1798.17) and the Federal Privacy Act (Public Law 93-579) require that this notice be provided when collecting

personal information from individuals. Information requested on this form is voluntary and will be used for the purposes of identification and to determine eligibility for

benefits under the provisions of the Military and Veterans Code, Sections 890 through 899 and 980 and Education Code, Section 66025.3. The program is administered by:

Deputy Secretary, Veterans Services Division, 1227 "O" Street, Sacramento, CA 95814. Failure to provide requested information will result in the delay or denial of benefits.

Individuals may review available personal records during normal business hours. Appeals of denied benefits shall be filed with the Veterans Services Division (note address

above). Appeals must be in writing, stating the reasons you feel the benefits should be granted, and filed within 90 days after the date of the "letter of denial."

DVS-40 (1/17)

Form Dvs-40 - College Fee Waiver Program For Veterans Dependents - California - 2017 Page 2

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