If you have a written contract or an agreed payment schedule, bring it up to reinforce your request. It's just an extra step we're taking to verify the returns we process and make sure refunds go to the right person.Fill out a Request for Hardship Determination (VA Form 1010HS). Write a letter explaining why you're requesting a hardship determination. You'll need to submit a Financial Status Report (VA Form 5655) as part of your request for help with certain VA repayment or debt relief options. To request a payment, you'll need either a UVA Vendor Registration Number (Supplier Number) or an Account Number at Alumni Hall. Make them payable to the U.S. Department of State. Yes, you must fill out the juror information form and detach it from the bottom of the summons. You must mail in the completed form to us within 5 days. Must I respond to my jury duty summons?