Microsoft Word - Form TVC-ED-1-Texas_Hazlewood_Act_Exemption

TexasHazlewoodActExemptionApplication

SupportingDocumentationInstructions

TVC‐ED‐1a

Revised 01DEC21

Page1of1

TEXASVETERANSCOMMISSION

Phone:1‐877‐898‐3833or512/463‐3168|TTY/TDD:Dial711|Fax:512/463‐3932|E‐Mail:hazlewood@tvc.texas.gov|Web:www.tvc.texas.gov

AnEqualOpportunityEmployer



ToapplyfortheTexasHazlewoodActExemption,

youmustsubmit the following documents to your college or university:

1. TheHazlewoodExemptionApplication with supporting documents,completed andsigned.

2. ReportofSeparationorDischarge,DDForm214(andDDForm215iftheDDForm214hasbeenamended)–To

verifytheVeteran’splaceofentry,homeofrecordatthetimeofentry,characterofservice,lengthofservice,and

datesofservice.Thecopyyouprovidetoyourinstitutionmustbelegibleandcontaintheinformationlistedabove.

• ADDForm214maybeobtainedfromtheNationalArchives: https://www.archives.gov/veterans .

• IftheVeteranwasdischargedpriortoJanuary1,1950previouslyusedseparationdocumentsmaybeused. If

the Veteran’sDD Form214 wasdestroyedin the NationalArchives firein 1973 orisotherwiseunavailable,

thenthe followingdocumentsmaybeused:

• NAForm13038,CertificationofMilitaryService

• DocumentationfromtheNationalArchivesthattheVeteran’sNAForm13038wassentinlieuoftheDDForm

214duetotheDDForm214notbeingonfile

• Documentation that Veteran met the requirements of Subchapter B, Chapter 54, Texas Education Code for

residenttuitiononthedateofentryintoactivedutyindicatedontheDDForm214

3. Certificate of Eligibility for Federal GI Bill benefits – ToverifyeligibilityfortheVeteran’s,ordependent’sfederal

educationbenefits, CertificatesofEligibility (CoE)maybeobtainedbycompletinganapplicationontheVeterans

Affairs websiteathttps://www.va.gov/education/how-to-apply/.

• IftheVeteran’sfinaldischargeispriorto9/11/2001theCertificateofEligibilityisnotrequired for the Veteran.

• A VA Certificate of Eligibility may be required by the school for a Legacy, a Child with own hours, and a Spouse to

determine if the Hazlewood Act beneficiary has any Chapter 33/Post-9/11 GI Bill benefits.

4. IftheVeterandiedwhileinservice:ReportofCasualty,FormDDForm1300–ToverifytheVeteran’splaceofentry

orhomeofrecord,andthathis/herdeathwasservicerelated.

5. If the Veteran is deceased (not service connected) – Death Certificate for deceased Veteran for use in a Legacy

transfer.

6. IftheVeteranistotallydisabledorindividuallyunemployableduetomilitaryservice‐relatedillnessorinjury:You

musthaveacurrent(withinoneyear)disabilityratingsdecisionletterfromtheVAindicatingthatrating.

7. IfyouarenottheVeteran,RelationshipDocumentation–Submitoneormoreofthefollowingdocumentstoverify

yourrelationshiptotheeligibleVeteran.

• BirthCertificate,orMarriageCertificate,orAdoptionPapers,orRecentIRSTaxTranscript:

https://www.irs.gov/individuals/get‐transcript.

8. VeteransmustresideinthestateofTexasduringthetermthattheexemptionwillbeused.

• ChildrenandspouseofeligibleVeteransmustbeclassifiedasaTexasresidentbytheirinstitution.

9. HazlewoodOnlineDatabaseRegistration–TocomplywiththeFederalEducationalRightsandPrivacyAct(FERPA)

requirements,allapplicants(Veterananddependents)mustregisterintotheHazlewoodonlinedatabasetousethe

HazlewoodExemptionathttps://hazlewood.tvc.texas.gov/students/.

TexasHazlewoodActExemption

Application

TVC‐ED‐1

Revised 01DEC21

Page1of2

TEXASVETERANSCOMMISSION

AnEqualOpportunityEmployer



For(Term) (Year) at(Institution)

*Submitthisapplicationtoyourcollegeoruniversity,nottotheTexasVeteransCommission*

EachVeteran,child,orspouseapplyingtoreceiveanexemptionthroughtheHazlewoodAct,(TexasEducation

Code §54.341) must complete and sign this application and provide the institution with the documentation

required to verify eligibility as indicated in this packet. Submit this application and all supporting

documentationtoyourinstitution’sHazlewoodActExemptionadministrator.

Iamapplyingas(checkonlyone):

[

]aVeteranintendingtousemyHazlewoodAct exemption(CompleteA,C,&D)

]achildreceivingaLegacytransferofan eligible Veteran's Hazlewood Act benefit(CompleteA, B, C, & E)

]achildofaHazlewood Act eligible Veteran who is totallydisabled,service‐relateddeceased,KIA,orMIA (CompleteA, B, C, & D)

]aspouseofaHazlewood Act eligible Veteran who is totallydisabled,service‐relateddeceased,KIA,orMIA(CompleteA, B, C, & D)

Iam(checkonlyone):

[ ]anapplicantapplyingforthefirsttime;or

[ ]apreviousHazlewoodrecipientwhohasusedhoursatinstitution(s).

Totalpriorhoursused:Veteran,Legacy

(transferredhrs.)

,Spouse,Child

(w/ownhrs.)

Veteran’sName:

LastName FirstName MI

Veteran’sSSN: DateofBirth://

(MM/DD/YYYY)



Veteran’sStudentID#(ifapplicable):

Address:

Street City State ZipCode

PhoneNumber: Emailaddress:

RelationshiptoVeteran:

[

]BiologicalChild[ ]Step‐child[ ]AdoptedChild[ ]IRSDependent[ ]Spouse

Child’s/Spouse’sName:

LastName FirstName MI

Child’s/Spouse’sSSN: DateofBirth://

(MM/DD/YYYY)



Child’s/Spouse’sStudentID#:(ifapplicable)

PermanentAddress:

Street City State ZipCode

PhoneNumber: Emailaddress:

To qualify for the Hazlewood Exemption, the Veteran, child or spouse cannot be indefaultonaloanthatis

madeorguaranteedbythestateofTexas.Stateloanscanbeviewedathttp://www.hhloans.com/.

DoestheVeteran,childorspousehavealoanthroughtheTexasHigherEducationCoordinatingBoard?

[

]Yes [ ]No

Ifyes,istheloanindefaultstatus?

[ ]Yes [ ]No [ ]NotApplicable

PartA

–

Veteran’sInformation

PartB

–

OtherUserInformation

PartC

–

LoanVerification

TexasHazlewoodActExemption

Application

TVC‐ED‐1

Revised 01DEC21

Page2of2

TEXASVETERANSCOMMISSION

AnEqualOpportunityEmployer



TheTexasHazlewoodActExemptionentitleseligible personstoanexemptionoftuitionandspecifiedfeesof

upto150semestercredithoursatpublicinstitutionsofhighereducationinTexas.Exceptforrecipientswho

arethespouseorchildrenofeligibleVeteranskilledinaction,missinginaction,orwhosedeathresultedfrom

a service‐related injury  or illness; all other Hazlewood recipients meet the grade point average satisfactory

academicprogressrequirementsandotherrequirementsofTexasEducationCode§54.2001.

IgrantpermissiontoanyinstitutionIhaveenrolledinorintendtoenrollintoreleasecredithourinformation

pertainingtomyenrollmenttotheTexasVeteransCommissionandtheTexasHigherEducationCoordinating

Board, and further grant permission to the Commission and Board to share such information with any

institutionthatImightattend.IcertifythattheinformationIhaveprovidedistrueandcorrecttothebest of

myknowledge.IfurtherunderstandthatifIhaveprovidedinaccurate,incomplete,oruntrueinformationon

thisapplication,Imayberequiredtoreimbursetheinstitutionfortuition,fees,andpenaltiespertainingtothe 

HazlewoodExemption.

Veteran’sSignature: Date:

(Veteran’ssignatureisnotrequirediftheeligibleVeteranistotallydisabled,service‐relateddeceased,MIA,orKIA.)

Child’s/Spouse’sSignature: Date:

(Ifapplicable.)

*Submitthisapplicationtoyourcollegeoruniversity,nottotheTexasVeteransCommission*

The Texas Hazlewood Exemption allows eligible Veterans or a designee to transfer all unused hours of the

exemption,upto150semestercredithours,toachildwhois25yearsoldoryoungeronthefirstdayofthe

term.Legacyrecipientswillreceiveanexemptionforthenumberofdegreecertifiedhoursassociatedwiththe

specificdegreeorcertificateprogramheorsheisenrolledinconsistentwiththe programlengthasdefinedin

the school catalog as approved by the regional accreditation commission. Legacy recipients must meet the

gradepointaveragesatisfactoryacademic progressrequirementsandotherrequirementsofTexasEducation

Code§54.2001.AssignedhoursmayberevokedbytheVeteranorthedesignee.

I(Veteran) waivetherighttoalloftheunusedportionofmyHazlewood

Exemption and grant permission to transfer those unused Hazlewood hours under Texas Education Code

§54.341(k)(LegacyAct)tomyeligiblechild,(child) .Iagreetorelease

current term and historic credit hour information to the Texas Veterans Commission and the Texas Higher

Education Coordinating Board to determine the balance of my unused hours. I grant permission for the

CommissionandBoardtosharesuchdatawithanyinstitutionthatmyeligiblechildmightattend.Iunderstand

thatonly oneeligiblepersonmay usemy hoursfora particularterm. Ihereby certifythe informationI have 

providedis true andcorrect.I understand that if Ifail toprovide accurateinformation, I may be requiredto

reimbursetheinstitutionandpenaltiesmaybeimposed.

Veteran’sSignature: Date:

* IfthequalifyingVeteranisdeceased,the Veteran’sDesignee(PrintName)

maysignaboveinVeteran’splace*

Veteran’sChild’sSignature: Date:

*Submitthisapplicationtoyourcollegeoruniversity,nottotheTexasVeteransCommission*

PartD

–

Veteran,Child,andSpouseCertificationandConsent

PartE

–

LegacyChildCertificationandConsent