VA Form 5655, Financial Status Report is a document used for claiming a payment plan, the acceptance of a compromise offer, or as a waiver for debt. The information collected via the VA Form 5655 is used by the Department of Veterans Affairs (VA) to determine eligibility for the corresponding claim. Individuals eligible to submit the request include veterans, beneficiaries, payees, representatives acting on the debtor's behalf, or the representatives of an estate.
The latest version of the form was released on June 1, 2009. An up-to-date VA Form 5655 fillable version is available for download below. Filing the form is voluntary. However, if the requested data is not provided it may affect the applicant's eligibility for the waiver, compromise or a payment plan.
A printable non-fillable version of the VA 5655 can be found on the Department of Veterans Affairs website. The form - also known as the Financial Status Report Portable Document File - should be printed, filled out with a pen or typewriter, and mailed or faxed.
Pressing the PRINT button will only print the current page. Download the document to your desktop, tablet or smartphone to be able to print it out in full.