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VA Form 1100 Agreement to Pay Indebtedness
What Is VA Form 1100?
V A Form 1100, Agreement to Pay Indebtedness , is an official form used by the individual who owes money to the U.S. Department of Veterans Affairs (VA) and is prepared to take proactive steps to handle the debt. Whether you have a debt related to your disability compensation, loans approved by the VA, pension payments, or education benefits, do not waste time and contact the VA to confirm you are still willing to pay the debt. You can calculate how much money you can afford to pay each month toward the debt in question, negotiate the terms of the repayment with the VA, and slowly handle the debt until you do not owe anything. A different monthly payment plan will let you deal with the debt over time if you are having a financial hardship due to unemployment or illness.
This document was issued by the VA on October 1, 1992 , with all previous editions obsolete. A VA Form 1100 fillable PDF can be found via the link below.
VA Form 1100 Instructions
VA Form 1100 instructions are as follows:
- Enter the number of your VA file and identify the payee if you know them.
- State your full name and the payment code you have used to make your payments up until that moment.
- Confirm you are aware of the existing debt to the VA in your name. Write down the type and the amount of debt you have incurred after participating in a benefits program offered to you by the VA.
- Choose the option most convenient to you - you are allowed to make the repayment by paying once a month to the VA agent cashier or by authorizing deductions from your salary. Record the amount of payment you are able to provide and the date the money is to be paid or withdrawn. If you select the former option, add the name and address of the VA station.
- Confirm you know potential benefits may be withheld until you handle the repayment of your debt. Write down your address, sign and date the document.
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