Submitting a Financial Status Report (VA Form 5655)

You'll need to submit a Financial Status Report (VA Form 5655) as part of your request for help with certain VA repayment or debt relief options. Read below to learn more about this report and how to submit one.

Financial Status Report (VA Form 5655) basics

You need to submit a Financial Status Report (VA Form 5655) when you want to request any of these debt repayment or relief options:

• Repayment plan of over 5 years
• Compromise offer
• Waiver

There are certain cases when you can request help without a Financial Status Report:

• As part of our COVID-19 relief efforts, you don’t need to submit a Financial Status Report for repayment plans of 5 years or less
• If you submitted a Financial Status Report to the Debt Management Center in the past 6 months, you don’t need to submit a new one unless you have changes to report. For example, you’ll need to submit a new report if you’ve lost your job or gotten a new job since your last report.

In these cases, call us at 800-827-0648 (or 1-612-713-6415 from overseas). We’re here Monday through Friday, 7:30 a.m. to 7:00 p.m. ET. If you have hearing loss, call TTY: 711.

When you request help with a VA debt, we want to make sure we fully understand your financial situation. If you’re married, we also need to understand your spouse’s financial situation. This helps us accurately assess your household's finances.

Your report gives us details about your finances and other factors that affect how much you can pay on your debt. This helps us make the best decision on your request.

When you submit a Financial Status Report, we sometimes ask for a personal statement.

We ask you to tell us why you’re requesting a certain debt relief option. This helps us understand your situation so we can make the best decision on your request.

If you request one of these debt relief options, you’ll need to include a personal statement:

• For a compromise offer, explain why you're asking to pay less than the full amount of the debt. Tell us the one-time amount you're offering as full payment.
• For a waiver request, explain why you feel you shouldn’t have to repay the debt. Share more information that you haven’t already shared in writing and that isn't in your VA records. You can also request an oral hearing.

If you request help with debt online, we give you space to add your statement. If you request help by mail or in person, you’ll need to write a letter and include it with your report.

For debt related to VA disability compensation, non-service-connected pension, or education benefits

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.
  Get VA Form 5655 to download

Mail your form and statement to:

U.S. Department of Veterans Affairs

Debt Management Center

For debt related to VA health care copays

Fill out and sign VA Form 5655. Write your personal statement in a separate document.

Send your form and statement by mail, or bring them in person, to the business office or health administration office at your nearest VA medical center.

You can contact a Veterans Service Officer (VSO) or other accredited representative. These trusted professionals are trained and certified to help you with VA-related needs.

To find a VSO:

• Go to eBenefits to find a local representative (including a recognized VSO, an attorney, or a claims agent) by state/territory, zip code, or the organization’s name.
  Go to eBenefits
• Or search the VA Office of the General Counsel’s list to find VA-recognized organizations and VA-accredited individuals by name, city, state, or zip code.
  Search the VA Office of the General Counsel’s list

Questions you may have while you fill out VA Form 5655

You'll need this information (for both you and your spouse if you’re married):

• Work history for the past 2 years. You'll need the employer name, start and end dates, and monthly income for each job.
• Income. This includes money you earn from a job, VA or Social Security benefits, or other sources. You’ll find the details you’ll need on a recent paycheck.
• Assets. These include cash, savings, stocks and bonds, real estate, cars, jewelry, and other items of value.
• Monthly living expenses. These include housing, food, and utilities (like gas, electricity, and water).
• Other living expenses. These include expenses like clothing, transportation, child care, or health care.
• Installment contracts or other debts. These include car loans, student loans, credit card debt, and other debts or purchase payment plans.
• Bankruptcy information. If you've ever declared bankruptcy, you'll need the date discharged, court location, and docket number.

Estimate the amount of money you think you would get if you sold the item in your local community. To get an idea of prices, you can check these places:

• Online forums for your community
• Classified ads in local newspapers
• Websites that appraise the value of cars or other items

We accept estimated amounts.

If you work different hours or earn different amounts each month:

Tell us the average amount you earn each month, as best you can. If you reported wages on your tax return for last year, you can divide those reported wages by 12 and use that amount.

If you have expenses that vary from month to month:

Tell us the amount you paid on your last month's bill. Or, add up how much you spent over the past year and divide by 12 to get an estimated monthly amount.

This may apply to expenses like gas, electricity, or cell phone bills.

If you have expenses you don't pay each month:

Try to find receipts for the past year. Then, add up how much you spent for the year and divide by 12 to get an estimated monthly cost.

This may apply to expenses like clothing or health care copay costs.

Note: You don't need to send us copies of your bills or receipts when you request help. We may ask you to share more information as we review your request.

You’ll find the VA file number and deduction code for each debt printed in these 2 places:

• In the upper right corner of your debt collection letters
• On the left side of your payment remittance stubs. You'll find these stubs at the bottom of each collection letter.

In many cases, we use your Social Security number for your VA file number.