Form VA Form 22-6553c VA Form 22-6553c Monthly Certification of Flight Training

OMB Approved No. 2900-0162
Respondent Burden: 30 minutes
Expiration Date: XX/XX/20XX

MONTHLY CERTIFICATION OF FLIGHT TRAINING
IMPORTANT: Read Privacy Act Notice, Respondent Burden and Instructions on page 2 before completing this form.
1. FIRST-MIDDLE-LAST NAME OF STUDENT

3. REPORTING PERIOD

2. FILE NUMBER

A. BEGINNING DATE

B. ENDING DATE

5. IF TRAINING WAS COMPLETED OR TERMINATED DURING
REPORTING PERIOD, GIVE DATE (State reason in Item 11,

4. ADDRESS OF STUDENT (Complete only if this is a change from your address of record)

Remarks)

6. NAME OF CURRENT COURSE

7. FLIGHT INSTRUCTION FURNISHED FOR CURRENT COURSE DURING REPORTING PERIOD
A. TYPE OF INSTRUCTION

B. HORSE POWER

C. HOURS

D. RATE

$

E. AMOUNT

$

8A. COST TO STUDENT FOR INSTRUCTION DURING THIS REPORTING PERIOD (Excluding any taxes, if applicable)

$

8B. STATE AND LOCAL SALES TAXES (If applicable)

$

8C. TOTAL COST TO STUDENT THIS REPORTING PERIOD (Including taxes, if applicable)

$

9. TOTAL COST TO STUDENT FOR THIS COURSE THROUGH END OF REPORTING PERIOD

$

10. SUMMARY OF TOTAL HOURS IN COURSE THROUGH END OF REPORTING PERIOD
TYPE OF INSTRUCTION

MAXIMUM APPROVED

HOURS GIVEN
TO DATE

TYPE OF INSTRUCTION

A. DUAL

MAXIMUM
APPROVED

HOURS GIVEN
TO DATE

C. PRE-FLIGHT
AND POST FLIGHT

DUAL SIMULATOR
(Do not include in dual above)

D. GROUND

B. SOLO

E. OTHER

11. REMARKS (Indicate any substitution, flight test or variance from approval course)

CERTIFICATION: I CERTIFY THAT the above entries are true and correct.
12. PRINTED NAME OF SCHOOL CERTIFYING OFFICIAL

13A. SIGNATURE OF SCHOOL CERTIFYING OFFICIAL
(Sign in ink)

14. NAME AND ADDRESS OF FLIGHT SCHOOL

15. FACILITY CODE

VA FORM
XXX XXXX

22-6553c

SUPERSEDES VA FORM 22-6553c, SEP 2022,
WHICH WILL NOT BE USED.

13B. DATE SIGNED

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INSTRUCTIONS FOR FLIGHT SCHOOL OPERATORS
1. You should complete this form after the last day of the month unless the student's training was interrupted or completed before the end of the month.
2. You will expedite the student's payments by sending these certifications to the appropriate Regional Office. These certifications are due to VA as
early as possible after the end of the month in order to effect prompt payment.
3. Item 3: Show the beginning and ending dates for the reporting period during which the student received training.
4. Item 6: Show the name of the course the student is pursuing. If the student completes or interrupts the course for any reason, enter the date in Item 5,
and the reason in Item 11.
5. Item 7: Report each type of instruction separately, as shown in the example below. Flight time should be reported in accordance with Part 1.1 of FAR
1, i.e., from the moment power is applied for the purpose of flight until the time the plane lands and taxis to a final rest.
A. TYPE OF INSTRUCTION
GROUND SCHOOL
PRE-FLIGHT/POSTFLIGHT
SOLO
DUAL
FLIGHT TRAINING DEVICE

B. HORSEPOWER

100
150

C. HOURS
4.0
1.5
2.0
3.0
2.0

D. RATE
$8.00
10.00
25.00
40.00
10.00

E. AMOUNT
$32.00
15.00
50.00
120.00
20.00

6. Item 8: Report the total charges for instruction given during the reporting period shown in Item 3.
7. Item 9: Report the total charges incurred from the beginning of the course through the end of the current reporting period. If student enrolls in a new
flight course during the period, separate certifications must be submitted for both courses.
8. Item 10: Report the maximum hours approved and the cumulative hours completed for each type of instruction through the end of the current
reporting period. NOTE: Flight instruction in any category, including type of aircraft, may not exceed the approved maximum hours.
9. Item 11: Report any substitution, flight test, or variance from the student's approved course, or any change in enrollment and training status. Examples
of such changes are the student substitutes an aircraft not approved for the course or the student's conduct or progress was unsatisfactory.
CAUTION: Willful submission of false information may result in fine or imprisonment or both.
PRIVACY ACT NOTICE: VA will not disclose information collected on this form to any source other than what has been authorized under the
Privacy Act or Title 38, Code of Federal Regulations 1.576 for routine uses 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. An example of a routine use allows VA to
send 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) for VA to obtain 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. Your response is required to obtain or retain benefits. The responses you submit are
considered confidential (38 U.S.C. 5701). Any information provided by applicants, recipients, and others may be subject to verification through
computer matching programs with other agencies.
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 2900-0162, and it expires XX/XX/20XX. Public reporting
burden for this collection of information is estimated to average 30 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 [email protected]. Please refer to OMB Control No. 2900-0162 in any correspondence. Do not send
your completed VA Form 22-6553c to this email address.

VA FORM 22-6553c, XXX XXXX

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