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VA 5655 2024-2026 free printable template

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This form is used to report financial information to determine eligibility for waiver of a debt, acceptance of a compromise offer, or for a payment plan related to benefits from the Department of
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How to fill out form 5655 fillable

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How to fill out va form 5655

01
Obtain VA Form 5655 from the VA website or local VA office.
02
Read the instructions carefully before filling out the form.
03
Provide your personal information, including your name, Social Security number, and VA file number.
04
Fill out the section detailing your income, including employment earnings, benefits, and any other sources of income.
05
Report your monthly expenses in the designated section, including housing, utilities, food, and medical expenses.
06
List your assets, such as bank accounts, real estate, and vehicles.
07
Include information regarding your debts and liabilities.
08
Sign and date the form to certify that the information is complete and accurate.
09
Submit the completed form to the appropriate VA office.

Who needs va form 5655?

01
Veterans seeking financial assistance from the VA.
02
Individuals applying for VA benefits who need to demonstrate their financial situation.
03
Dependents of veterans applying for aid.
04
Anyone seeking debt relief or mortgage assistance through the VA.

Who needs a VA-5655 form?

Former military serviceman needs to fill out a VA Financial Status Report (form VA-5655) for Department of Veterans Affairs to accompany one of the following documents: (1) request for a compromise offer; 2) request a monthly payment plan; 3) request for a waiver. All of these documents relate to changes in the debt obligations of the applicant.

What is VA-5655 form?

VA-5655 form provides information about employment, income, expenses, assets, installment contracts and other debts of the former serviceman who is acting as the applicant in one of the cases mentioned above.

Is VA-5655 form accompanied by other forms?

VA form 5655 must accompany a VA financial hardship form, VA debt waiver form, request for a compromise offer.

When is the VA-5655 form due?

There are no specific deadlines for submission of this particular form. VA-5655 form accompanies the main document and may be submitted at any time.

How do I fill out the VA-5655 form?

The VA form 5655 instructions for filling are found here http://www.va.gov/. You should provide such information: 1) personal data; 2) complete record of employment for yourself and spouse; 3) income and expenses records; 4) assets; 5) installment contracts and debts.

Where do I send the VA-5655 form?

The main document and completed VA-5655 form should be sent to:

U.S. Department of Veterans Affairs Debt Management Center
P.O. Box 11930 St Paul, MN 55111 1-612-970-5688 (fax)

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People Also Ask about va form financial status report

If you're struggling because of life situations like losing your job, having a sudden decrease in income, or having an increase in out-of-pocket family health care expenses, we can help. You can request financial hardship assistance to manage your current VA copay debt or request an exemption from future copays.
You'll need to submit these 2 items: A Financial Status Report (VA Form 5655) A personal statement that explains why you feel you shouldn't have to repay the debt. In your statement, share more information to support your waiver request.
We offer 4 repayment or relief options for benefit-related VA debt: Monthly offsets. If you get VA benefit payments, we may keep (or “offset”) part or all of each payment to pay down your debt. This is how we'll collect your debt unless we approve another option.
You can submit your completed VA Form 5655 and personal statement in either of these 2 ways: Online: Our online form includes a section for your personal statement. Submit your Financial Status Report online. By mail: Fill out and sign VA Form 5655. Write your personal statement in a separate document.
The law requires that a military retiree waive a portion of their gross DoD retired pay, dollar for dollar, by the amount of their Department of Veterans Affairs (VA) disability compensation pay; this is known as the VA waiver (or VA offset).
You'll need to submit these 2 items: A Financial Status Report (VA Form 5655) A personal statement that explains why you feel you shouldn't have to repay the debt. In your statement, share more information to support your waiver request.
The VA may withhold future benefits or send this to a collection agency. The VA can also garnish wages or file a suit in federal court. They are also able to withhold approval on a VA home loan. If you receive Social Security benefits, the VA may withhold these as well.
If you're struggling because of life situations like losing your job, having a sudden decrease in income, or having an increase in out-of-pocket family health care expenses, we can help. You can request financial hardship assistance to manage your current VA copay debt or request an exemption from future copays.
PRIVACY ACT INFORMATION: The information you furnish on this form is almost always used to determine if you are eligible for waiver of a debt, for the acceptance of a compromise offer or for a payment plan. Disclosure is voluntary.

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VA Form 5655, also known as the Financial Status Report, is a form used by the Department of Veterans Affairs to assess an individual's financial situation.
VA Form 5655 is typically required to be filed by veterans and other individuals seeking financial assistance or benefits from the VA, particularly when requesting a waiver of overpayment.
To fill out VA Form 5655, an individual must provide accurate information about their income, expenses, assets, and liabilities. It may be helpful to gather financial documents before starting and to complete each section as clearly as possible.
The purpose of VA Form 5655 is to gather necessary financial information to evaluate a veteran's financial status for benefits, debt repayment, or assistance programs.
Information that must be reported on VA Form 5655 includes monthly income, monthly expenses, total assets, total liabilities, and other relevant financial details.
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