Response Contact

You will always need to complete the Response Contact section:

  1. Contact Name
  2. Contact Phone
  3. Contact Email
Response Contact section with Name, Phone, and Email fields

Response Details by Option

I already submitted a payment

Provide: Case Number, Payment Date, Amount Paid, Document Type, Payment Identifier, Comments

I already submitted a payment form fields

I never submitted an application with the listed case number

Provide: Case Number, Document Type, Comments

I never submitted an application form fields

I am awaiting dispute resolution

Provide: Case Number, Document Type, Comments (include dispute reason, date, method, DIR officer)

I am awaiting dispute resolution form fields

The listed case is a duplicate case

Provide: Case Number, Document Type, Comments

Duplicate case form fields

The listed outstanding amount is incorrect

Provide: Case Number, Document Type, Comments (include correct amount and reason)

Incorrect amount form fields

Other

Provide: Case Number, Payment Date (if applicable), Amount Paid (if applicable), Document Type, Payment Identifier (if applicable), Comments

Other option form with all fields