Items 1 to 2B: eligible person
The first name, middle initial and last name of the eligible person, the VA file number and the eligible person's email address.
22-1999c
Certificate of Affirmation of Enrollment Agreement—Correspondence Course
- Agency
- VA
- Revision
- January 2025
- Fillable fields
- 9
- Pages
- 2
- Official source
- VA form page
- Checked
- October 20, 2026
VA Form 22-1999c: Affirmation of Enrollment Agreement, Correspondence Course
VA Form 22-1999c is the U.S. Department of Veterans Affairs Certificate of Affirmation of Enrollment Agreement for a correspondence course. The eligible person who signed an enrollment agreement with a correspondence school uses it to affirm that agreement. The form says the Correspondence School Agreement is not effective unless this form is completed and returned to the school.
The form explains that the affirmation provision gives the person no less than five full days after signing the enrollment agreement to reflect on the decision to enroll and decide whether the course suits their abilities and interests. It says VA will not accept any affirmation signed before the 7th day.
The form is two pages. Page 1 holds Items 1 to 7, the purpose and procedure text and the instructions for the claimant and the school. Page 2 holds the Privacy Act notice and the respondent burden. The student returns the signed copies to the school, and the school sends VA Copy 1 to VA with VA Form 22-1999, Enrollment Certification. You can fill out the PDF free in your browser on this page and download the result without an account.
What's on VA Form 22-1999c
Items 3 to 5: course and school
The name of the course, the date the enrollment agreement was signed and the name and address of the school.
Purpose and affirmation procedure
The purpose of the affirmation provision of law, then two choices: A, a decision not to affirm, and B, a decision to affirm only after the expiration of 5 full days after the day the agreement was signed.
Affirmation statement
A paragraph saying the person has read and understands the enrollment agreement dated in Item 4, affirms it and certifies under penalty of law that the certificate was not signed until after the 5 full days.
Items 6 and 7: date and signature
The date signed and the signature of the eligible person.
Page 2 notices
The Privacy Act notice and the respondent burden, estimated at 3 minutes, under OMB Control No. 2900-0576, which expires 01/31/2028.
How to complete VA Form 22-1999c
- 1
Fill in Items 1 to 5
Enter the eligible person's name, VA file number and email, the course name, the date the enrollment agreement was signed and the school's name and address.
- 2
Wait the five full days
The form's example: if the contract was signed on the 1st day of a month, the affirmation is signed and dated on or after the 7th day. VA will not accept an affirmation signed before the 7th day.
- 3
Read the affirmation paragraph
The form says to read the paragraph above Items 6 and 7 before completing them.
- 4
Sign and date it
Complete Item 6, the date signed, and Item 7, the signature of the eligible person.
- 5
Return two copies to the school
The instruction to the claimant is to return VA Copy 1 and School Copy 2 to the school named in Item 5. The school then submits VA Copy 1 with VA Form 22-1999.
Why fill Form 22-1999c on indox
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- The official blank straight from the VA, not a copy someone retyped
- Works on a phone, tablet or computer
Where it goes
To the school
The form says to return VA Copy 1 and School Copy 2 of the form to the school identified in Item 5 after completing Items 6 and 7 on or after the 7th day.
From the school to VA
The form says the school should submit VA Copy 1 of VA Form 22-1999c and VA Form 22-1999 (Enrollment Certification) to VA. The form prints no VA mailing address.
Payment for lessons
The form says VA will not pay for lessons that you complete and the school services before the proper affirmation date.
Edition
The JAN 2025 edition supersedes VA Form 22-1999c, OCT 2022, which will not be used. It carries OMB Control No. 2900-0576, which expires 01/31/2028.
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Who uses VA Form 22-1999c?
The form's instructions say who signs it and who sends it to VA.
Official sources and the blank
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Questions about Form 22-1999c
What is VA Form 22-1999c used for?
It affirms an enrollment agreement for a correspondence course. The form says the Correspondence School Agreement is not effective unless this form is completed and returned to the school.
When can the affirmation be signed?
The form says only after the expiration of 5 full days after the day the agreement was signed. Its example is a contract signed on the 1st day of a month, with the affirmation signed on or after the 7th day.
What if I decide not to affirm the agreement?
The form says not to sign this form and to destroy it. It says you may notify the institution at any time, and that the institution, without imposing any penalty or fee, shall make full refund of all amounts paid.
Who sends VA Form 22-1999c to VA?
The school. The student returns VA Copy 1 and School Copy 2 to the school, and the school submits VA Copy 1 with VA Form 22-1999, Enrollment Certification.
Does VA pay for lessons finished before the affirmation?
The form says VA will not pay for lessons that you complete and the school services before the proper affirmation date.