Application for Public Safety Officers' Educational Assistance

Application for Public Safety Officers' Educational Assistance

education with required docs.xlsx

Application for Public Safety Officers' Educational Assistance

OMB: 1121-0220

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Education
Letter of Representation <Authorized Representative> To act as an authorized representative you must provide a signed "Letter of Authorization" from the adult applicant(s) you are representing that certifies you have been asked to act on their behalf.

Additional Educational Assistance Documentation  <Student> In order to process your PSEOA Application, you must provide supporting documentation regarding any educational assistance received for the terms you are requesting reimbursement. To meet this requirement, you may include a letter from the source of the assistance or a billing statement from the school that lists the source and assistance amount. You do not need to submit any paperwork for work-study programs or loans that have to be paid back (unless those loans are in default).

Birth or Marriage Certificate  <Student> When the spouse or child of a Public Safety Officer applies for education benefits, evidence of relationship between the public safety officer and applicant must be provided to the PSOB Office as part of the application process.

Parent-Child Relationship Confirmation  <Child> A parent-child relationship is defined as a relationship between a Public Safety Officer and another individual, in which the officer has the role of parent (other than biological or legally-adoptive). There are several documents that PSOB accepts as evidence of a parent-child relationship. Examples of accepted documents may include: 1) statements from school administrators, church clergy, or social workers that describe the relationship between the Public Safety Officer and the child. 2) Tax documentation showing that the child was claimed as a dependent by the Public Safety Officer. 3) Statements confirming that the child in question received more than half of their support from the Public Safety Officer, or which shows that the primary residence of the child was the same as the Public Safety Officer.

Transcripts/ Grades  <Student> When requesting retroactive educational assistance for courses that have already been completed, please include copies of your transcripts, and indicate the terms for which you are seeking reimbursement.

Enrollment Verification   <Student> Whether applying for a future term or terms you've already completed, include a statement from your educational institute on school letterhead indicating that you have attended the institution or will be attending in the future. The statement must include the dates of each term you attended (or will attend), and your status as a full-, three-quarter-, half-, or less-than-half-time undergraduate or graduate student.

Class Schedule   <Student> When requesting prospective educational assistance, please provide a copy of your finalized schedule of classes for the term, including the number of credits awarded for each course.

Tuition Billing Statement   <Student> Please provide an invoice or billing statement from the educational institution that includes the dates and terms the student is being billed.
OTHER MATERIALS On-campus Housing School Billing Statement N/A
Off-campus Housing Copy of Lease N/A
Receipts, bills, or lists of titles and costs if not yet purchased Books N/A
General Mileage, Meals eaten on campus, groceries for off-campus living. N/A
Computer Supplies Receipt N/A
Utilities for Off-Campus Housing Copy of bills or cancelled checks for phone service, internet service; gas or electric bills) N/A
School Meal Plan School Billing Statement N/A








































































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