Facility and trainee boxes
The name and facility code of the training facility, the trainee's name and address, the VA file number and the payee number.
22-6553d-1
Monthly Certification of On-the-Job and Apprenticeship Training
VA Form 22-6553d-1 is the U.S. Department of Veterans Affairs Monthly Certification of On-the-Job and Apprenticeship Training. It is an employer form, not a trainee application. The form says the employer completes, dates and signs it on or after the last day of the last month shown in Item 1, and its instructions are addressed to the certifying official. It reports the hours a trainee trained each month, whether the trainee pursued the approved program and whether the wage rate follows the training agreement.
The form is two pages. Page 1 holds the training facility and trainee details, the instructions, Items 1 to 9 and the Privacy Act and respondent burden notices. Page 2 lists the two VA Regional Processing Offices and the states each one serves. The Privacy Act notice says VA cannot pay the student any education benefits until it receives the information. You can fill out the PDF free in your browser on this page and download the result without an account.

The name and facility code of the training facility, the trainee's name and address, the VA file number and the payee number.
The month or months and year to be certified, and the number of hours trained for each month, including any hours of related training given during working hours.
Whether the trainee was pursuing the approved program for the months shown, and if not, the date terminated and the reason. Item 5 also shows if the trainee attained the complete job skills of a journeyman.
Whether the wage rate is in accordance with the training agreement, and if not, the new rate and its effective date.

More information on a change in the wage rate, a change in the number of dependents for a trainee receiving additional educational allowance for dependents, or unsatisfactory conduct or progress.
A certification that the statements are true and correct, the penalty statement, the certifying official's printed name and title, the date signed and the signature in ink.
The form says the employer completes, dates and signs it on or after the last day of the last month shown in Item 1.
List each month and year in Item 1 and the hours trained in Item 2, including any hours of related training given during working hours.
Check a box in Item 3. If training was terminated, complete Items 4 and 5.
Answer Item 6A. If the trainee received a wage increase or decrease not in accordance with the training agreement, show the new rate in 6B and its effective date in 6C.
Use Item 7 for any extra information, then enter the certifying official's name, title and date in Items 8A and 8B and sign Item 9 in ink.
Send it to the Regional Processing Office that handles claims for the state in which the training facility is located, listed on page 2.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
VA Regional Office, P.O. Box 4616, Buffalo, NY 14240-4616. It serves CO, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD, ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ, NY, OH, PA, RI, SD, TN, VA, VT, WI, WV, WY, APO/FPO AA, foreign schools and the US Virgin Islands.
VA Regional Office, P.O. Box 8888, Muskogee, OK 74402-8888. It serves AK, AL, AR, AZ, CA, FL, GA, HI, ID, LA, MS, NM, NV, OK, OR, PR, SC, TX, UT, WA, APO/FPO AP, Guam, the Philippines, American Samoa and the Mariana Islands.
The form says to send it to the Regional Processing Office that handles claims for the state in which your training facility is located.
The form lists 1-888-GI-BILL-1 (1-888-442-4551), and the Federal Relay number 711 for users of the Telecommunications Device for the Deaf (TDD).
The JAN 2025 edition supersedes VA Form 22-6553d-1, DEC 2021, which will not be used. It carries OMB Approved No. 2900-0178, which expires 01/31/2028.
22-8864
142 fields, 5 pages
22-8865
47 fields, 2 pages
22-6553c
54 fields, 2 pages
22-8794
68 fields, 3 pages
22-1990
155 fields, 7 pages
The form opens with the name and facility code of the training facility. It says the employer completes, dates and signs the form.
The instructions are addressed to the certifying official, who gives a printed name and title in Item 8A, the date in Item 8B and a signature in ink in Item 9.
The trainee's name and address, VA file number and payee number appear at the top of the form. The form has no trainee signature line.
Page 2 says to send the completed form to the Regional Processing Office that handles claims for the state in which the training facility is located.
The form is completed by the employer or training facility about a trainee, and sent to VA.
The agency’s own page for Form 22-6553d-1.
The official blank form, to print or fill by hand.
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The employer. The form says the employer completes, dates and signs it, and its instructions are addressed to the certifying official. The form has no trainee signature line.
The form says on or after the last day of the last month shown in Item 1.
The instructions say to enter the number of hours trained for each month shown, including any hours of related training given during working hours.
If the trainee received a wage increase or decrease not in accordance with the training agreement, the instructions say to show the new rate and its effective date in Items 6B and 6C, with any more detail in Item 7.
Check No in Item 3 and complete Items 4 and 5 with the termination date and reason. If the trainee attained the complete job skills of a journeyman, the instructions say to show this in Item 5.
To the Regional Processing Office for the state where the training facility is located: P.O. Box 4616, Buffalo, NY 14240-4616 or P.O. Box 8888, Muskogee, OK 74402-8888.