OMB box and Paperwork Reduction Act statement
OMB Control Number 3090-0080, expiration date 9/30/2027, a 6 minute time estimate and an address for comments on the estimate.
GSA1142
Release of Claims
- Agency
- GSA
- Revision
- Rev. 5/2015
- Fillable fields
- 13
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 1142: Release of Claims
GSA Form 1142 (GSA 1142), Release of Claims, is a one-page General Services Administration (GSA) form, printed as GSA 1142 (REV. 5/2015) with OMB Control Number 3090-0080 and an expiration date of 9/30/2027. GSA hosts it in its forms library, and GSA's page lists PBS P 2800.6A as its authority or regulation.
The form is a statement by the undersigned contractor on a numbered contract between the United States of America and the contractor. In its words, the contractor does "hereby release the United States from any and all claims arising under or by virtue of said contract or any modification or change thereof except as follows", and it asks the contractor to list any claims against the Government and the amounts thereof, or, if none, to so state.
The contractor signs with a witness, and the form has a place for a seal. GSA estimates it will take 6 minutes to read the instructions, gather the facts and answer the questions. You can fill it out free in your browser on this page and download the result without an account.
What's on GSA 1142
Contract details
Lines for the contract number, what the contract is for and where it is located.
Release statement
The printed release of the United States from any and all claims arising under or by virtue of the contract or any modification or change thereof, except as listed.
Claims excepted
Lines to list any claims against the Government and the amounts thereof. The form says if none, so state.
Date, signatures and seal
A line for the day and month of signing, the contractor's name, signature and official title, a seal, and the witness's signature and address.
How to complete GSA 1142
- 1
Enter the contract number
Fill in the contract number on the first line.
- 2
Describe the contract and its location
Complete the lines for what the contract is for and where it is located.
- 3
List any claims excepted
The form says to list any claims against the Government and the amounts thereof, and if none, so state.
- 4
Date the release
Fill in the day and month on the line that begins Witness the signature and seal of the undersigned, and the line below it.
- 5
Sign as contractor
Print or type the contractor's name, add the seal, then sign and enter the official title.
- 6
Have a witness sign
The witness signs and enters an address in the WITNESS block.
Why fill Form GSA1142 on indox
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Where it goes and what the form says
Where it goes
The PDF gives no filing address. It names no office that receives the signed release.
Not the comments address
The Paperwork Reduction Act statement says to send only comments relating to the time estimate to U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.
OMB number and time estimate
OMB Control Number 3090-0080, expiration date 9/30/2027. GSA estimates 6 minutes to read the instructions, gather the facts and answer the questions.
What GSA's page says
GSA's page lists form number GSA1142, a current revision date of 05/2015 and PBS P 2800.6A as the authority or regulation.
Related forms
Who signs GSA 1142?
The form is written as a statement by the contractor, witnessed by a second person.
Official sources and the blank
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Questions about Form GSA1142
Who issues GSA 1142?
The footer reads GENERAL SERVICES ADMINISTRATION and GSA 1142 (REV. 5/2015), and the form carries OMB Control Number 3090-0080. GSA hosts it in its forms library.
Who signs GSA 1142?
The undersigned contractor signs over the word CONTRACTOR, with a printed or typed name, a seal and an official title. A witness signs and gives an address.
What if the contractor has claims to keep?
The release applies except as listed on the form. The form says to list any claims against the Government and the amounts thereof, and if none, so state.
Where do I send GSA 1142?
The PDF gives no filing address. The GSA address in its Paperwork Reduction Act statement is only for comments relating to the time estimate.
How long does GSA 1142 take?
GSA estimates it will take 6 minutes to read the instructions, gather the facts and answer the questions.
When does the OMB approval expire?
The form shows OMB Control Number 3090-0080 with an expiration date of 9/30/2027.