We need this form in order to receive, respond to, and refer complaints regarding
VA educational
assistance benefits. This information can only be obtained from the individual respondent.
Executive Order 13607 allows us to ask for this information. We estimate that you will need
an average of 20 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
www.reginfo.gov/public/do/PRAMain.
If desired, you can call 1-800-827-1000 to get information on where to send comments or suggestions about this form.