INFORMATION
(The items that are considered self-explanatory are not included in these instructions)
ITEM 3. If you (or the veteran or service member) were previously assigned an 8-digit file number, enter this number.
ITEM 6. If you have not previously applied for VA education benefits, go to www.benefits.va.gov/gibill/, and click on "Apply for Benefits". See
the top of this form for the education benefits that permit reimbursement of Licensing or Certification tests.
ITEM 7. Write the complete name of the test.
ITEM 8. Write the complete name and complete mailing address (including ZIP Code) of the organization issuing the license or certificate (not
necessarily the organization that administered the test).
ITEM 9. Show the date you took the test and attach a copy of your test results. (If you do not have any test results but have a copy of your license
or certification and a payment receipt for your test, attach these documents.) Reimbursement of the test fee can't be paid until this information is
received. Please provide this information for the test you want to receive reimbursement.
ITEM 10. Enter the cost of the test you took, including any required fees. (We can only reimburse you for required test fees.) We
have no authority to reimburse you for any optional costs related to the test process. Test fees that VA will reimburse include
"registration fees," fees for specialized tests, and administrative fees such as a proctoring fee. Fees that VA has no authority to
reimburse include fees to take pre-tests (such as Kaplan exams), fees to receive scores quickly, or other costs or fees for optional items that are not
required to take an approved test.
ITEMS 12 and 13. Sign and date the form.
Additional Information: You may provide additional information that you think will help VA process your claim. Attach additional sheets of paper
to this application if necessary. Additional information should be properly labeled (such as: Item 1, if the additional information supports Item 1 on
the form).
MORE 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 use the
Telecommunications Device for the Deaf (TDD), the Federal Relay number is 711. You can also get education assistance at our education Internet
site: https://www.va.gov.
HOW TO FILE YOUR CLAIM: Send the completed application to the Regional Processing Office for your region. The addresses for your
region are listed in the chart below.
RESPONDENT BURDEN: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The
OMB control number for this project is 2900-0695, and it expires XX/XX/20XX. Public reporting burden for this collection of information is estimated to average 15 minutes per respondent, per year,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments
regarding this burden estimate and any other aspect of this collection of information, including suggestions for reducing the burden, to VA Reports Clearance Officer at VACOPaperworkReduAct@va.
gov. Please refer to OMB Control No. 2900-0695 in any correspondence. Do not send your completed VA Form 22-0803 to this email address.
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., VA sends 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) VA obtains 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) as identified in the VA system of records, 58VA21/22/28, Compensation, Pension, Education, and Veteran Readiness and Employment Records - VA, published in the Federal Register. Your
obligation to respond is required to obtain or retain benefits (licensing and certification test reimbursement). While you do not have to respond, VA cannot reimburse you any licensing and certification test
fees until we receive this information (38 U.S.C. 3452(b) and 3501(a)). Your responses are confidential (38 U.S.C. 5701). Information submitted is subject to verification through computer matching
programs with other agencies.
VA FORM 22-0803, FEB 2022
Page 2
US VIRGIN ISLANDSFOREIGN SCHOOLSAPO / FPO AAWY
WV
WIVT
VATNSDRIPAOHNYNJ
NHNENDNCMTMOMNMIMEMD
MAKYKSINIL
IA
DE
DC
CT
CO
SERVES THE FOLLOWING STATES
Eastern Region:
VA Regional Office
P.O. Box 4616
Buffalo, NY 14240-4616
PHILIPPINESGUAMAPO / FPO AP
WAUTTXSCPROROKNVNMMS
LAIDHIGAFLCAAZARALAK
SERVES THE FOLLOWING STATES
Western Region:
VA Regional Office
P.O. Box 8888
Muskogee, OK 74402-8888
AMERICAN SAMOA
MARIANA ISLANDS