Va fsc vendor file request form va form 10091 2025

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  1. Click ‘Get Form’ to open the VA FSC Vendor File Request Form (VA Form 10091) in the editor.
  2. Begin by filling out the 'Payee/Vendor Information' section. Enter your DUNS number, SSN/TIN, and select your Payee/Vendor Type from the provided options.
  3. Next, complete the 'VA Facility Information' section. Input the station number, contact details including phone and email address, and ensure all information is accurate.
  4. In the 'Miscellaneous Actions' section, indicate if you qualify as a small business and provide your vendor name and DBA if applicable.
  5. Fill in your current and previous addresses, ensuring to include street, city, state, and zip code for both.
  6. For EFT/ACH information, enter your bank details including bank name, address, routing number, account number, and type of account.
  7. Finally, sign the document by entering your printed name and title before submitting it via secure fax or email as indicated.

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NOTE: The Request for Services (RFS) Form 10-10172 must be submitted via an approved method (HSRM, Electronic Fax, Direct Messaging, Traditional Fax, or Mail) to your local VA community care office.
To set up a repayment plan, fill out an Agreement to Pay Indebtedness (VA Form 1100). In paragraph 1A, tell us how much you can pay each month. Then submit your completed form and any other needed documentation to us.
Use VA Form 21-22 when you want to have a Veterans Service Organization (VSO) help you with VA benefits or claims.
VA Form 10091 is used to gather essential payment data from vendors (Commercial, Individuals, Veterans, etc.) to establish or update vendor records in order to process electronic payments in ance with Title 31 of the Code of Federal Regulation Part 208 (31 CFR Part 208).
To request either of these options, youll need to send us these 2 items: A Financial Status Report (VA Form 5655) A personal statement that explains why you feel you shouldnt have to repay the debt. For a compromise offer, include how much youre offering to pay. Dont send payment with your offer.

People also ask

What is VA financial hardship? Financial hardship for purposes of requesting expediting of your VA disability claim means that you, the veteran, are unable to earn enough income to pay essential expenses such as housing payments or medical expenses relating to your disability.
When to use this form. Use VA Form 21-10210 to submit a formal statement to support your VA claimor the claim of another Veteran or eligible family member. People also sometimes call this statement a buddy statement.

va fsc vendor file form