Financial Status Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 5655 Financial Status Report	Form	Modified	Available
2026-20414 30 Day 2900-0165.pdf	Supplementary Document	Uploaded 2026-10-06	Available
2026-15355 60 Day 2900-0165.pdf	Supplementary Document	Uploaded 2026-09-28	Available
2900-0165 Template 30-Day FRN_DRAFT 0928026.docx	Supplementary Document	Uploaded 2026-09-28	Available
VA-2026-VACO-0001-0350.pdf	Public Comments	Uploaded 2026-08-18	Available
2900-0165 Supporting Statement Part A_DRAFT 10062026.docx	Supporting Statement A	Uploaded 2026-10-06	Available
2900-0165 Template 60-Day FRN_DRAFT 07202026.docx	Supplementary Document	Uploaded 2026-07-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
260945	Financial Status Report	Form	Modified	Financial Status Report

ICR Details

OMB Control No: 2900-0165	ICR Reference No: 202607-2900-008
Status: Received in OIRA	Previous ICR Reference No: 202306-2900-026
Agency/Subagency: VA	Agency Tracking No: 2900-0165
Title: Financial Status Report
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/06/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	11/30/2026
Responses	150,871	33,335
Time Burden (Hours)	150,871	33,335
Cost Burden (Dollars)	5,060,213	992,050

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Abstract: The major use of the form is to document and support the eligibility determinations for waivers of collection, for the consideration of compromise offers, determine financial hardship suspensions, and/or for assisting in the development of repayment plans for overpayment debts owed to the VA.

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Authorizing Statute(s): US Code: 38 USC 5302 Name of Law: Waiver of recovery of claims by the United States
   US Code: 38 USC 5314 Name of Law: Indebtedness offsets
   US Code: 31 USC 3711 Name of Law: Collection and compromise
   US Code: 38 USC 3716 Name of Law: Administrative offset
   US Code: 38 USC 3717 Name of Law: Interest and penalty on claims
   US Code: 38 USC 3718 Name of Law: Contracts for collection services
   US Code: 38 USC 5316 Name of Law: Authority to sue to collect certain debts
   US Code: 5 USC 5514 Name of Law: Installment deduction for indebtedness to the United States
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 48229	07/30/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 63673	10/06/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Financial Status Report	5655	Financial Status Report

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	150,871	33,335	0	0	117,536	0
Annual Time Burden (Hours)	150,871	33,335	0	0	117,536	0
Annual Cost Burden (Dollars)	5,060,213	992,050	0	0	4,068,163	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden has increased since the previous approval due to the resumption of collections of debts that were suspended during the Coronavirus 2019 (COVID-19) Pandemic. Collection was paused on new debts effective April 2020 at the Debt Management Center (DMC). Collection action resumed beginning May 2022 for suspended debts, and additional debts continue to be created, returning operations to normal. Additionally, DMC also no longer requires VA Form 5655 to approve repayment plans extending 60 months or fewer. Previously, VA Form 5655 was required to approve repayment plans extending greater than 12 months. Repayment plans on compensation and pension benefit overpayments now also automatically extend for 36 months instead of 12 months when over the minimum monthly payment threshold. Form usage has fluctuated due to the above-mentioned policy changes and collections restarting.

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Annual Cost to Federal Government: $1,071,155

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/06/2026

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