Texas A&M University-Commerce

Hazlewood Exemption Application for Eligible Dependents

of Texas members of the U.S. Armed Forces Who Have Never Used the Exemption (Form HE-D)

Eligibility Requirements and Documentation

In order to qualify for a tuition and partial fee exemption through the Texas Education Code 54.203 (known as the Hazlewood Act), the child of certain deceased or disabled Texas member of the Armed Forces or Texas National Guard must meet all program requirements. The following is a list of program requirements and how they are documented.

Eligibility Requirements	Application Questions	Documentation
Dependent is a resident of Texas at the time he/she uses the exemption	N/A	Institution’s classification as a resident by the registrar or admissions office.
Parent died or is rated totally disabled for purposes of employability as a result of illness/injury related to service	N/A	DD1300 issued by the Department of Defense (if parent died while still in the service); letter from VA if parent died after discharge. Ratings Disability letter from VA if parent is rated as unemployable.
You were dependent on or after the date the parent died or sustained the disabling injury or was declared by VA as unemployable because of the injury.	Question 5	Dependency can be shown by providing the college a copy of a tax return indicating dependency at the time the parent died or became disabled.
Dependent is not in default on a loan made or guaranteed by the state or federal government	Question 6	Institution verification through national and state loan clearinghouses
Value of the dependent’s federal veterans’ education benefits does not exceed the value of the Hazlewood exemption (tuition and fees less property deposit and student service fees)	Question 7	Benefit letter from VA Education Center in Muskogee, Oklahoma, 1888-442-4551 or www.gibill.va.gov
Parent was a United States Citizen at time of entry.	Question 8	If your parent was not a US citizen at the time of entry you do not qualify for this exemption.
Parent was a resident of Texas at the time of entry.	Question 9	You will need to complete Parts BE of the application to provide information the school will used to determine whether your parent met this requirement.

Eligible Periods of Service

Texas Education Code 54.203 indicates the following individuals may be eligible for an exemption through the Hazlewood Act:

(A) nurses and honorably discharged members of the armed forces of the United States who served during the Spanish-American War or during World War I;

(B) nurses, members of the Women's Army Auxiliary Corps, members of the Women's Auxiliary Volunteer Emergency Service, and honorably discharged members of the armed forces of the United States who served during World War II except those who were discharged from service because they were over the age of 38 or because of a personal request on the part of the person that he be discharged from service;

(C) honorably discharged men and women of the armed forces of the United States who served during the Korean War which began on June 27, 1950, and ended on July 27, 1953; and

(D) all persons who:

(i) were honorably discharged from the armed forces of the United States after serving on active military duty for at least 181 days, excluding training; and

(ii) who served a portion of their active duty during:

(I ) the Cold War which began on June 27, 1950;

(II ) the Vietnam era which began on December 21, 1961, and ended on May 7, 1975;

(III) the Grenada and Lebanon era which began on August 24, 1982, and ended on July 31, 1984;

(IV) the Panama era which began on December 20, 1989, and ended on January 21, 1990;

(V) the Persian Gulf War which began on August 2, 1990, and ended on March 3, 1991;

(VI) the National Emergency by Reason of Certain Terrorist Attacks, which began on September 11, 2001; and

(VII) any future national emergency declared in accordance with federal law.

Instructions for Completing Application HE-D.

Question 1-4		Self-explanatory
Question 5.		In order for you to qualify, you must have been a dependent of your parent when he/she died or was determined to be unemployable due to disabilities or sustained the injury that lead to unemployability. To meet this requirement you must give your institution an income tax return or other document that shows you were claimed as a dependent for federal tax purposes at the appropriate time.
Question 6.		Persons in default on a loan made or guaranteed by the federal government or the State of Texas may not use the exemption. Your institution will verify your response to this question.
Question 7.		To use the exemption, your federal veterans’ benefits may not exceed the value of your potential Hazlewood Exemption (tuition and fees less property deposit and student service fees). To prove you meet this requirement you must provide your institution a copy of a letter from the VA Education Center in Muskogee, Oklahoma, indicating your current status with regard to federal education benefits. Their phone number is 1-888-442-4551.
Questions 8.		For you to qualify, your parent must have been a citizen of the United States at the time of entry into the Armed Forces.
Question	9.	To qualify for this exemption your parent must have been a resident of Texas at the time of entry. This will need to be documented through the evaluation of your response to a Parent’s Residency Form.

Documents to Submit.

To apply for a Hazlewood Exemption, you must submit the following documents to your institution:

1 . The Hazlewood Exemption Application for Eligible Dependents of Texas Members of the U. S Armed Forces Who have Never Used the Exemption (HE-D)

2 . If parent died while in service,

o DD1300 – for use in verifying your parent’s place of entry, and that his/her death was service-related.

3. If parent died after discharge as a result of service-related illness or injury,

o DD214 – to verify parent’s place of entry

o Letter from VA – to confirm death was related to service

4. If parent became unemployable due to service-related illness or injury,

o Ratings Decision Letter – to confirm the parent is considered to be totally disabled with respect to employability.

5. Benefits letter from Muskogee, Oklahoma – to verify the status of your federal veterans’ education benefits. This letter can be acquired by calling 1-888-4424551.

The easiest way to acquire a copy of the DD214 or DD1300 is to contact the VA regional office

in Waco or Houston, whose addresses are:

Houston Regional Office

6900 Almeda Road

Houston, TX 77030-4200

1-800-827-1000 713-383-5340

Waco Regional Office

One Veteran Plaza
701 Clay Avenue
Waco, TX 76799
1-800-827-1000
254-299-9774

To receive a copy of the Ratings Decision Letter, contact the Waco Regional Office.

Hazlewood Exemption Application for
Eligible Dependents of Texas Members of the U.S. Armed Forces
Who have Never Used the Exemption

Each person wishing to receive an exemption through the Hazlewood Act (Texas Education Code 54.203) must complete and sign the following application and provide his/her institution documentation of eligibility as indicated below.

Part A. Basic Applicant Data

1. Name: ________________________________ 2. Social Security Number: ___________________

last, first, middle initial

3 Term for which you are applying for the exemption: ______________________/____________ (fall/spring or summer) / year

4. Deceased or disabled Parent’s Name ____________________________

SSN: _____________________________

5. Were you claimed as a dependent for income tax purposes by your parent in the year in which he/she died or became unemployable due to injuries sustained while in the service or in the year in which the injuries occurred that resulted in unemployability? [ ] yes [ ] no

6 Are you currently in default on an education loan made or guaranteed by the state of Texas or federal government? [ ] yes [ ] no

NOTE: This will be verified by your institution.

7. Are you currently eligible to receive benefits under Title 38, United States Code, Chapters 30, 32, 35 or Title 10, United States Code, Chapters 1606 or 1607?

[ ] yes [ ] no

8. Was your parent a citizen of the United States at the time he/she entered the service? [ ]yes [ ]no

If you answered “no”, you are not eligible for the Hazlewood Exemption. There is no need to submit an application.
If you answered “yes”, continue to question 9.

4 When your parent entered the service,

(a) Was he/she a Texas resident at that time? [ ] yes [ ] no

If you answered “no”, you are not eligible for the Hazlewood Exemption. There is no need to submit an application.

Part B. Veteran/Parent High School Graduation or Receipt of GED

1 Did your parent (the member of the military) graduate from a TX high school or received a GED in TEXAS having lived in the state the 36 months leading up to graduation or receipt of the GED? [ ]yes [ ]no

2 Did he/she live in Texas the 12 months prior to enlistment? (The year prior to enlistment may include time enrolled in high school or completing the GED.) [ ] yes [ ] no

If you checked “yes” to BOTH questions, skip to Part G.

Part C. Parent’s Dependent Status at time He/she Entered the Service

At the time he/she entered the service, which of the following circumstances applied to your parent?

[	]	a.		Filed his/her own federal income tax as an independent tax payer.
[	]	b. Was claimed as a dependent by a parent or court-appointed legal guardian.
[	]	c.	If you did not check “a” or “b” above, who provided the majority of his/her support?
		[ ] self [			] parent or guardian	[	] other*:

Explanation for “other” person providing him/her support:

if you checked “a” or “self” under “c”, continue to Part D.
If you checked “b” or “parent or guardian under “c”, skip Part D and go to Part E.
If you checked “other” please explain below, skip Part D and answer Part E for the

individual who provided your parent support.

Part D. For Those Whose Parent Filed His/Her Own Income Tax (Checked “a” to Question C, Above).

1 Was your parent living in Texas when he/she entered the service? [ ] Yes [ ] No

2. If he/she was living in Texas when he/she entered the service,

a. how long had your parent resided in Texas at that time? Yrs & Mos

b. what was his/her MAIN reason for being in Texas? (If “other”, give explanation.)
[ ] Born & Raised Here [ ] Go to College [ ] Accept a Job [ ] Military Assignment [ ] Other

c. if it was for Military Assignment, what was his/her home of record? __________________

3. If he/she was not living in Texas when he/she entered the service,

a. how long had your parent resided outside of Texas at that time? Yrs & Mos

b. what was his/her MAIN reason for being out of state? (If “other”, give explanation.) [ ] Go to College [ ] Accept a Job [ ] Military Assignment [ ] Other

c. if it was for Military Assignment, what was his/her home of record? __________________

Part E. Questions for Students Whose Parent was a Dependent at the Time He/She Entered the Service. All students who answered “Parent” or “Legal Guardian” or “other” in Part C must complete this section.

The following questions apply to your parent’s parent or legal guardian, which (for simplicity) we will refer to as your grandparent.

1 Name of grandparent who claimed your parent as a dependent at the time he/she entered the service:

2 Relationship to your parent: [ ] parent [ ] legal guardian [ ] other __________

3. Was your grandparent a U.S. Citizen or Permanent Resident when your parent entered the service? If not, which of the following categories did she meet?

a. [ ] Applicant for Permanent Resident Status.

b. [ ] Foreign National with a visa to live in the United States. If you checked this box, what type of visa is it? Visa type: ____________

c. [ ] Foreign National without a visa.

4. If your grandparent was living in Texas when your parent entered the service,

a. how long had your grandparents resided in Texas at that time? Yrs & Mos

b. what was your grandparent’s MAIN reason for being in Texas? (If “other”, give explanation.) [ ] Born & Raised Here [ ] Go to College [ ] Accept a Job [ ] Military Assignment [ ] Other

c. if it was for Military Assignment, what was his/her home of record? __________________

3. If your grandparent was not living in Texas when your parent entered the service,

a. how long had your grandparent resided outside of Texas at that time? Yrs & Mos

b. what was his/her MAIN reason for being out of state? (If “other”, give explanation.) [ ] Go to College [ ] Accept a Job [ ] Military Assignment [ ] Other

c. if it was for Military Assignment, what was his/her home of record? __________________

Part E. Comments. If there is additional information you believe your institution should have in order to determine your parent’s residence at the time he/she joined the service, please provide it here.

Part G. Certification and Consent to Disclosure

My name is ________________________________ and I am applying for an exemption from payment of tuition and certain fees under Texas Education Code, Section 54.203 (The Hazlewood Act). I understand that I may be entitled, under the law, to this exemption for up for 150 credit hours total at Texas public institutions of higher education. For the purpose of accounting for the total number of hours for which I receive this exemption, I am granting permission to any institution in which I have enrolled or will enroll to release current semester and historic credit hour information to the Texas Higher Education Coordinating Board ("Board") and am granting permission for the Board to share such data with any institution that I might attend. 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.

Signature Date

For Institution Use Only

Approved (initials):	Muskogee ltr on file? [ ] yes [ ] no	Resident now? [ ] yes [ ] no
Term VA benefit amnt: $______	Proof of dependency? [ ] yes [ ] no	In default? [ ] yes [ ] no
	Ratings Disability Letter indicates unemployability? [ ] yes [ ] no
HS 36 mo in TX? [ ] yes [ ] no	Parent’s Residency Support TX? [ ] yes [ ] no [ ] n/a This applies to parts C-F of this application.
U S Citizen? [ ] yes [ ] no