U.S. Department of Veterans Affairs

<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> <html lang="en"> <head>  <meta http-equiv="Content-Type" content="text/html; charset=UTF-8; X-Content-Type-Options=nosniff;"> <meta name="language" content="en"> <meta name="author" content="Department of Veterans Affairs"> <meta name="subject" content="[This page contains some information to those persons who owe VA]"> <meta name="keywords" content="[Department of Veterans Affairs, veterans, Enteprise, Entrepreneur, Franchise Funds, Fund, VA Enterprise Centers,DMC, Veterans Benefits Administration, Veterans Health Administration, VA debts, debt, VA benefits, benefits, debts, administrative offset, delinquent, Cooperative Support Administrative Unit, autodialer, telephone solicitation, solicitation, Treasury, DCIA, Debt Collection Improvement Act, debt collection, collection, debt managment, federal debt, medical debt, offset, collections, CASU, franchise activity, GMRA, government management reform act, NPR, MCCR, medical care cost recovery, medical care expense, medical expenses, expenses, veterans, VA customers, account, VA account, account maintenance]"> <meta name="datecreated" content="20060101"> <meta name="datereviewed" content="20210310"> <META HTTP-EQUIV="CACHE-CONTROL" CONTENT="NO-CACHE"> <META HTTP-EQUIV="PRAGMA" CONTENT="NO-CACHE">  <title>U.S. Department of Veterans Affairs - Pay Online</title> <script type="text/javascript" src="/ruxitagentjs_ICA7NVfqrux_10303241106123517.js" data-dtconfig="app=01bb16253fa2269b|cuc=e0lcgmjb|mel=100000|expw=1|featureHash=ICA7NVfqrux|dpvc=1|lastModification=1743609338533|tp=500,50,0|rdnt=1|uxrgce=1|agentUri=/ruxitagentjs_ICA7NVfqrux_10303241106123517.js|reportUrl=/rb_65aa2f7a-2a1d-4836-9cfb-f98e8ba3af74|rid=RID_-1273555936|rpid=460501254|domain=va.gov"></script><style type="text/css" media="screen,print"> @import url(/va_files/2009/styles/va-user-styles.css); @import url(/va_files/2009/styles/vaSearch.css); @import url(/va_files/2009/styles/jkmegamenu.css); @import url(/va_files/2009/styles/va-styles.css); @import url(web.css); </style> <style type="text/css" media="screen"> #prBanner { display:none; } </style> <style type="text/css" media="print"> #prBanner { padding:0px; margin:0px; border:0px; position: relative; } #banner-wrapper { display:none; } #banner-area-menu { display:none; } #footer-area-links { display:none; } </style> <script src="https://code.jquery.com/jquery-1.12.1.min.js"></script> <script type="text/javascript" src="./dropdown.js"></script> </head> <body class="mainbody"> <div id="skiplink"> <a href="#content-wrapper">skip to page content</a> </div>  <div class="bdywrpr">  <img src="/va_files/2009/images/inter-header-banner-print.gif" id="prBanner" width="996" height="100" alt="United States Department of Veterans Affairs" title="United States Department of Veterans Affairs">   <div id="banner-wrapper">  <div id="banner-image"> <a href="http://www.va.gov/" title="United States Department of Veterans Affairs"><img src="/va_files/2009/images/inter-header-banner-va-seal.gif" width="538" height="94" alt="United States Department of Veterans Affairs" title="United States Department of Veterans Affairs"></a> </div>   <div id="banner-area-search"> <div id="search-area"> <form name="searchForm" id="searchForm" method="GET" action="https://www.index.va.gov/search/va/va_search.jsp" style="margin:0px; 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<strong>Mozilla Firefox 1.5</strong> or greater; <strong>Mozilla 1.7</strong> or greater; <strong>Netscape 7.x</strong>; OR, <strong>Safari 1.2</strong> (for MAC users).</span> <hr class="dash_border"> </p> <h2 class="msg_red_under_xl_ital_bold">PLEASE DO NOT MAKE PAYMENTS ON THIS WEB SITE IF:</h2> <h3 class="msg_blk_bg_bold" >YOU ARE PAYING A VA MEDICAL CO-PAYMENT</h3> <p>DMC does not collect nor have information concerning medical billing statements. If you wish to make a VA medical co-payment <a href="https://www.pay.gov/paygov/forms/formInstance.html?nc=1279716484463&agencyFormId=25987221" title="Make a VA medical co-payment">click</a> here. If you need help completing the co-payment form call 866-400-1238. </p> <h3 class="msg_blk_bg_bold">YOU HAVE RECEIVED A COLLECTION LETTER FROM THE DEPARTMENT OF THE TREASURY GIVING YOU 10 DAYS TO MAKE PAYMENT TO AVOID FURTHER COLLECTION ACTION</h3> <p>If Treasury has sent you this letter, making a payment on this Web site will only delay application of the payment and will not preclude Treasury from adding fees to the amount you owe. Questions regarding Treasury collection should be directed to the telephone number on the Treasury collection letter. </p> <h3 class="msg_blk_bg_bold">YOU HAVE RECEIVED COLLECTION LETTERS OR PHONE CALLS FROM A PRIVATE COLLECTION AGENCY OR LAW FIRM</h3> <p>This means the Department of the Treasury has referred your account for private collection. Making payments on this Web site will delay application of those payments to your account and will not preclude fees charged by the collection agencies or law firms. </p> <div class="ybox"> <h2 class="msg_red_under_xl_ital_bold">ARE YOU CURRENTLY DRAWING VA BENEFITS AND PAYING THE BALANCE OF YOUR DEBT?</h2> <p> If you are currently drawing VA benefits, it is possible that your debt has been offset from your next benefit check. To avoid overpaying your debt, you should contact the Debt Management Center at 800-827-0648 (TTY: 711) to confirm your balance <u><i>before making a payment</i></u>. If you make a payment and your debt balance is already cleared through offset, it can take up to 60 days to refund your payment. So please call before you make your payment. If you have difficulty getting through to DMC, we ask for your patience. We have added more telephone lines and operators and are making every effort to improve service. </p> </div> <br> <div align="center"><a href="#info" id="top2" class="pagetitle2" title="Click to go to privacy information section" class="redtext">Read Important Privacy Information</a></div> <br> <div class="dash_border2"> <div class="innercontent"> <div id="formPayOnline"> <form name="form1" action="index.cfm" method="post"> <p class="secmsgtop">If you do not have your debt letter or need assistance with this form, please call 800-827-0648 (TTY: 711), Monday-Friday, between 6:30am-6pm (Central)</p> <p class="redtext" align="center">* is required. <a href="#item_help" title="Click here to go to the help section">Help With This Form</a></p><div id="OBM" align="right" style="margin-top: -45px;"> <p><strong>OMB Number:</strong> 2900-0663<br /> <strong>Estimated Burden:</strong> 10 minutes<br /> <strong>Expiration Date :</strong> 10/31/2026 </p> </div> <a name="formsection" class="visuallyhidden">Pay Online Form</a> <div id="secVeteran"> <div class="sechd">Veteran Information</div> <div class="secmsg">Please have a copy of the Veteran Debt Letter sent from Debt Management Center in front of you to enter the correct information.</div> <div class="colfl"><span class="note">*</span><label for="account_number" class="item">File Number:</label></div> <div class="colfr"><input type="text" name="account_number" id="account_number" size="30" value="" title="'File Number' is your eight - or nine - digit VA claim number."> <div><span class="redtext"> </span></div> </div> <div class="clear"></div> <div class="colfl"><span class="note">*</span><label for="payee" class="item" title="'Payee Number' tells us whether the debtor is a veteran or service member, a child, a spouse, a vendee or parent of the veteran.">Payee Number:</label></div> <div class="colfr"><input type="text" name="payee" id="payee" size="30" value="" title="'Payee Number' tells us whether the debtor is a veteran or service member, a child, a spouse, a vendee or parent of the veteran."> <div><span class="redtext"> </span></div> </div> <div class="clear"></div> <div class="colfl"><span class="note">*</span><label for="entitled" class="item" title="'Person Entitled' is the first initial, middle initial (if there is one) and first four letters of the debtor's last name. If the entry on the collection letter after 'Person Entitled' does not have a middle initial, a blank will appear where the middle initial would be. Please leave the same space blank on this form.">Person Entitled:</label></div> <div class="colfr"><input type="text" name="entitled" id="entitled" size="30" value="" title="'Person Entitled' is the first initial, middle initial (if there is one) and first four letters of the debtor's last name. If the entry on the collection letter after 'Person Entitled' does not have a middle initial, a blank will appear where the middle initial would be. Please leave the same space blank on this form."> <div><span class="redtext"> </span></div> </div> <div class="clear"></div> <div class="colfl"><span class="note">*</span><label for="deduction" class="item" title="'Deduction code' is a number that tells us what type of benefit the debtor received when the debt was established.">Deduction Code:</label></div> <div class="colfr"><select name="deduction" id="deduction"> <option value="" selected>Select a Deduction Code</option> <option value="11" >11 - Education Ch 33 Book, Supplies, and Other</option> <option value="12" >12 - Education Ch 33 Book, Supplies, and Other</option> <option value="13" >13 - Education Ch 33 Book, Supplies, and Other</option> <option value="14" >14 - Education Ch 33 Book, Supplies, and Other</option> <option value="15" >15 - Education Ch 33 Book, Supplies, and Other</option> <option value="16" >16 - Education Ch 33 Housing</option> <option value="17" >17 - Education Ch 33 Housing</option> <option value="18" >18 - Education Ch 33 Housing</option> <option value="19" >19 - Education Ch 33 Housing</option> <option value="20" >20 - Education Ch 33 Housing</option> <option value="21" >21 - Loan Guaranty (Principal and Interest)</option> <option value="25" >25 - Loan Guaranty (Interest Only)</option> <option value="27" >27 - Education Ch 33 Book, Supplies, and Other</option> <option value="28" >28 - Education Ch 33 Book, Supplies, and Other</option> <option value="30" >30 - Compensation or Pension</option> <option value="32" >32 - Compensation or Pension Special Pay</option> <option value="35" >35 - Burial</option> <option value="36" >36 - Spina Bifida Special Pay</option> <option value="37" >37 - Spina Bifida</option> <option value="38" >38 - Reps Debts</option> <option value="39" >39 - Reps Debts Special Pay</option> <option value="41" >41 - Education Ch 34</option> <option value="44" >44 - Education Ch 35</option> <option value="45" >45 - Education Ch 35 Special Pay</option> <option value="47" >47 - Vocational Rehabilitation</option> <option value="48" >48 - Education Ch 33 Housing</option> <option value="49" >49 - Education Ch 33 Housing</option> <option value="50" >50 - Education Ch 33 Housing</option> <option value="51" >51 - Education Ch 33 Housing</option> <option value="52" >52 - Education Ch 33 Tuition, Fees, Yellow Ribbon (student liable)</option> <option value="53" >53 - Education Ch 1607 Special Pay</option> <option value="54" >54 - Education Ch 1607</option> <option value="55" >55 - Education Ch 1606 Special Pay</option> <option value="56" >56 - Education Ch 1606</option> <option value="57" >57 - Education Ch 30 VRAP</option> <option value="58" >58 - Education Ch 30 Special Pay</option> <option value="59" >59 - Education Ch 30</option> <option value="60" >60 - Trainee Tools</option> <option value="62" >62 - Education Ch 33 Tuition, Fees, Yellow Ribbon (student liable)</option> <option value="63" >63 - Education Ch 33 Tuition, Fees, Yellow Ribbon (school liable)</option> <option value="70" >70 - Education Ch 33 Special Pay</option> <option value="71" >71 - Education Ch 33 Book, Supplies and Other</option> <option value="72" >72 - Education CH 33 Housing
</option> <option value="73" >73 - Education Ch 33 – Ch 1606/Ch 30 Kickers</option> <option value="74" >74 - Education Ch 33 Tuition, Fees, Yellow Ribbon (student liable)</option> <option value="75" >75 - Education Ch 33 Tuition, Fees, Yellow Ribbon (school liable)</option> <option value="76" >76 - Education Ch 33 - Ch 1606/Ch 30 Kickers</option> <option value="77" >77 - Education Ch 33 - Ch 1606/Ch 30 Kickers</option> <option value="78" >78 - Education Ch 33 - Ch 1606/Ch 30 Kickers</option> <option value="79" >79 - Education Ch 33 - Ch 1606/Ch 30 Kickers</option> <option value="80" >80 - Education Ch 33 Tuition, Fees, Yellow Ribbon (student liable)</option> <option value="86" >86 - Education Ch 33 Tuition, Fees, Yellow Ribbon (student liable)</option> <option value="87" >87 - Education Ch 33 Tuition, Fees, Yellow Ribbon (student liable)</option> <option value="88" >88 - Education Ch 33 Tuition, Fees, Yellow Ribbon (student liable)</option> <option value="89" >89 - Education Ch 33 Tuition, Fees, Yellow Ribbon (student liable)</option> <option value="90" >90 - Education Ch 33 Tuition, Fees, Yellow Ribbon (student liable)</option> <option value="91" >91 - Education Ch 33 Tuition, Fees, Yellow Ribbon (school liable)</option> <option value="92" >92 - Education Ch 33 Tuition, Fees, Yellow Ribbon (school liable)</option> <option value="93" >93 - Education Ch 33 Tuition, Fees, Yellow Ribbon (school liable)</option> <option value="94" >94 - Education Ch 33 Tuition, Fees, Yellow Ribbon (school liable)</option> <option value="95" >95 - Education Ch 33 Tuition, Fees, Yellow Ribbon (school liable)</option> <option value="96" >96 - Education Ch 33 Tuition, Fees, Yellow Ribbon (school liable)</option> <option value="97" >97 - Education Ch 33 Tuition, Fees, Yellow Ribbon (school liable)</option> <option value="98" >98 - Education Ch 33 Tuition, Fees, Yellow Ribbon (school liable)</option> </select> <div><span class="redtext"> </span></div> </div> <div class="clear"></div> </div> <Br /> <div id="secPayer"> <div class="sechd">Payer Information</div> <div class="secmsg">The following questions must reflect the identity of the person making the payment.</div> <div class="colfl"><span class="note">*</span><label for="first_name" class="item" title="Enter the first name of the person whose credit card, debit card or bank account will be used to send us a payment.">First Name:</label></div> <div class="colfr"> <input type="text" name="first_name" id="first_name" size="30" value="" title="Enter the first name of the person whose credit card, debit card or bank account will be used to send us a payment."> <div><span class="redtext"> </span></div> </div> <div class="clear"></div> <div class="colfl"><span class="note">*</span><label for="last_name" class="item" title="Enter the last name of the person whose credit card, debit card or bank account will be used to send us a payment.">Last Name:</label></div> <div class="colfr"> <input type="text" name="last_name" id="last_name" size="30" value="" title="Enter the last name of the person whose credit card, debit card or bank account will be used to send us a payment."> <div><span class="redtext"> </span></div> </div> <div class="clear"></div> <div class="colfl"><span class="note">*</span><label for="dayphone" class="item" title="Enter the 10 digits daytime telephone number of the person whose credit card, debit card or bank account will be used to send us a payment. We will call if a problem is encountered with the payment.">Daytime Phone:</label></div> <div class="colfr"> <input type="text" name="dayphone" id="dayphone" size="30" value="" title="Enter the 10 digits daytime telephone number of the person whose credit card, debit card or bank account will be used to send us a payment. We will call if a problem is encountered with the payment." maxlength="16"> <div><span class="redtext"> </span></div> </div> <div class="clear"></div> </div> <br /> <div id="secPayment"> <div class="sechd">Payment Information</div> <div class="colfl"><span class="note">*</span><label for="payment_amount" class="item" title="Enter payment amounts in currency format.">Payment Amount:</label> </div> <div class="colfr"> <input type="text" name="payment_amount" id="payment_amount" size="30" value="$" title="Enter payment amounts in currency format."> <div><span class="redtext"> </span></div> </div> <div class="clear"></div> <div> If you intend to make recurring ACH debit payments from your bank account, the amount entered in the "Payment Amount" field should be the amount of each payment.<Br><Br /> Example: If you want to pay a total of $3,000 in three payments, then enter $1,000 in the "Payment Amount" field. <br /><br /> Credit Card payments should not exceed $24,999.99 per transaction. </div> <br /> <div class="secmsg">If you do not have your debt letter or need assistance with this form, please call 800-827-0648 (TTY: 711), Monday-Friday, between 6:30am-6pm (Central)</div> <div class="colfl"> </div> <div class="colfr"> <label for="resetbtn" class="visuallyhidden">Reset</label><input type="Reset" id="resetbtn" class="abutton" value="Reset" title="Reset form">  <label for="nextbtn" class="visuallyhidden">Next</label><input type="submit" id="nextbtn" class="abutton" name="submit" value=" Next -> " title="Go to next page"> <input type="Hidden" name="action" value="step2"> <input type="Hidden" name="requesttimeout" value="99999999"> </div> <div class="clear"></div> </div> </form> </div> </div> </div> <br /> <div> <strong>Warning:<br><br>This U.S. Government computer system is for official use only. The files on this system include Federal records that contain sensitive information. All activities on this system may be monitored to measure network performance and resource utilization; to detect unauthorized access to or misuse of the system or individual files and utilities on the system, including personal use; and to protect the operational integrity of the system. Further use of this system constitutes your consent to such monitoring. Misuse of or unauthorized access to this system may result in criminal prosecution and disciplinary, adverse, or other appropriate action.</strong> <br>  <div id="formhelp"> <p align="center" class="item_hdr2"><strong><a name="item_help">Help With This Form</a></strong></p> <div class="coltwolhelp item_label">File Number</div> <div class="coltworhelp">'File Number' is your VA claim number. This field must be 8 or 9 characters long.</div> <div class="clear"></div> <div class="coltwolhelp item_label">Payee Number</div> <div class="coltworhelp">'Payee Number' tells us whether the debtor is a veteran or service member, a child, a spouse, a vendee or parent of the veteran.</div> <div class="clear"></div> <div class="coltwolhelp item_label">Person Entitled</div> <div class="coltworhelp">'Person Entitled' is the first initial, middle initial (if there is one) and first four letters of the debtor's last name. If the entry on the collection letter after 'Person Entitled' does not have a middle initial, a blank will appear where the middle initial would be. Please leave the same space blank on this form.</div> <div class="clear"></div> <div class="coltwolhelp item_label">Deduction Code</div> <div class="coltworhelp">'Deduction code' is a number that tells us what type of benefit the debtor received when the debt was established.</div> <div class="clear"></div> <div class="coltwolhelp item_label">First Name</div> <div class="coltworhelp">Enter the first name of the person whose credit card, debit card or bank account will be used to send us a payment.</div> <div class="clear"></div> <div class="coltwolhelp item_label">Last Name</div> <div class="coltworhelp">Enter the last name of the person whose credit card, debit card or bank account will be used to send us a payment.</div> <div class="clear"></div> <div class="coltwolhelp item_label">Daytime Phone</div> <div class="coltworhelp">Enter the 10 digits daytime telephone number of the person whose credit card, debit card or bank account will be used to send us a payment. We will call if a problem is encountered with the payment.</div> <div class="clear"></div> <div class="coltwolhelp item_label">Payment Amount</div> <div class="coltworhelp">Enter payment amounts in currency format.</div> <div class="clear"></div> </div> <p align="center"><a href="#top" id="bottom" title="Click to go to Top of this Page">Top of Page</a></p> <p class="redtext" align="center"><strong>If you have questions, please call the VA Debt Management Center at 800-827-0648 (TTY: 711) between 6:30 am and 6:00 pm Central time.</strong><br /><br /></p> <p class="pagetitle" align="center"><a name="info"> </a>YOUR PRIVACY IS IMPORTANT TO US. PLEASE READ THE FOLLOWING:</p> <p><strong>Privacy Act Information:</strong> The information you furnish on this form, including your Social Security Number, is used to associate your payment with your accounts receivable record so that we may properly credit your account. Disclosure is voluntary. However, without disclosure, a credit card transaction or direct debit transaction cannot be processed. The responses you submit are confidential and protected from unauthorized disclosure by 38 U.S.C. 5701. The information may be disclosed outside the Department of Veterans Affairs (VA) only when authorized by the Privacy Act of 1974, as amended. The routine uses for which VA may disclose the information can be found in VA systems of records, including 58VA21/22, Compensation, Pension, Education and Rehabilitation Records-VA, and 88VA244, Accounts Receivable Records-VA. VA systems of records and alterations to the systems are published in the <em><strong>Federal Register</strong></em>. Any information provided by you, including your Social Security Number, may be used in computer matching programs conducted in connection with any proceeding for the collection of an amount owed by virtue of your participation in any benefit program administered by VA.</p> <p><strong>Respondent Burden:</strong>  We need this information to determine or verify your indebtedness to VA ... Title 38, United States Code, allows us to ask for this information. We estimate you will need an average of 10 minutes to review the instructions, find the information, and complete this form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed.</p><p> You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet page at <a href="http://www.reginfo.gov/public/do/PRAMain" target="new">http://www.reginfo.gov/public/do/PRAMain</a>.  If desired, you can call <strong> <a href="tel:+1-800-827-1000" title="1-800-827-1000">1-800-827-1000</a></strong> to get information on where to send comments or suggestions about this form. <p>If you have comments regarding this burden estimate or any other aspect of this collection of information, contact: </p> U.S. Department of Veterans Affairs<br> Debt Management Center<br> P.O. Box 11930<br> Ft. Snelling, MN 55111<br> 800-827-0648 (TTY: 711)<br> 612-970-5688 (fax)<br> </div><br/> <table width="100%"><tr> <td align="left" width="25%"><strong>Form Number: </strong> 2900-0663 </td> <td align="center" width="50%"><a href="#top" id="bottom1" title="Click to go to Top of this Page">Top of Page</a></td> <td align="center" width="25%"> <strong>Page Number :</strong>  1 </td></tr></table>  </div>  <hr id="content-footer-divider">  <div id="footer-area"> <p id="footer-area-links"> <a href="https://www.va.gov/" title="VA Home">VA Home</a> |  <a href="https://www.va.gov/privacy/" title="Privacy Policy">Privacy Policy</a> |  <a href="https://www.va.gov/foia/" title="FOIA">FOIA</a> |  <a href="https://www.va.gov/webpolicylinks.asp" title="Web Policies">Web Policies</a> |  <a href="https://www.va.gov/orm/NOFEAR_Select.asp" title="No FEAR Act Data">No FEAR Act Data</a> |  <a href="https://www.va.gov/general/site_map.htm" title="Site Index">Site Index</a> |  <a href="https://www.va.gov/ext_redirect.asp?url=http://www.usa.gov/&type=1" title="USA.gov">USA.gov</a> |  <a href="https://www.va.gov/ext_redirect.asp?url=http://www.whitehouse.gov/&type=1" title="White House">White House</a> |  <a href="https://www.va.gov/ext_redirect.asp?url=http://www.nationalresourcedirectory.gov/&type=1" title="National Resource Directory">National Resource Directory</a> |  <a href="https://www.va.gov/oig/" title="Inspector General">Inspector General</a> </p> <p id="footer-address">U.S. Department of Veterans Affairs - 810 Vermont Avenue, NW - Washington, DC 20420</p> </div>  <p id="footer-review">Reviewed/Updated Date: January 8, 2021</p> </div> </div>  </body> </html>

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U.S. Department of Veterans Affairs - Pay Online