Va Form 22-8794 - Designation Of Certifying Official(S) (Page 2 of 2) in pdf

5. THE FOLLOWING ARE DESIGNATED AS CERTIFYING OFFICIALS OF THIS SCHOOL

OR TRAINING ESTABLISHMENT (Continued)

C. FOR POSTSECONDARY EDUCATIONAL INSTITUTIONS ONLY - OFFICIALS DESIGNATED TO SIGN THE SCHOOL PORTION OF

VA FORM 22-1990T, APPLICATION AND ENROLLMENT CERTIFICATION FOR INDIVIDUALIZED TUTORIAL ASSISTANCE ARE:

NO.

NAME

TITLE

SIGNATURE

(1)

(2)

(3)

6. REMARKS

It is hereby certified that the Department of Veterans Affairs will be notified of any changes in the designations shown on this form as they occur.

7. SIGNATURE AND TITLE OF DESIGNATING OFFICIAL

8. DATE

PENALTY - The law provides that whoever makes any statement of a material fact knowing it to be false shall be punished by fine or imprisonment or both.

Privacy Act Notice: The 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 5, Code of Federal Regulations 1.526 for routine uses as identified in the VA system of records, 58VA21/22,

Compensation, Pension, Education and Rehabilitation Records - VA, and published in the Federal Register. An example of a routine use is allowing

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. VA cannot recognize you as the proper certifying official unless the information is furnished as required by existing law (38 U.S.C.

3680(g)). The responses you submit are considered confidential (38 U.S.C. 5701). Information submitted by applicants, recipients, and others is

subject to verification through computer matching programs with other agencies.

Important Notice About Information Collection: We need this information to identify you as the certifying official for your school or job training

establishment when reporting pursuit of training for veterans and other eligible persons (38 U.S.C. 3684). Title 38, United States Code, allows us to

ask for this information. We estimate that you will need an average of 10 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 form.

Va Form 22-8794 - Designation Of Certifying Official(S) Page 2

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