Locale
A Check One box at the top right with two choices: Regional and Central Office.
GSA1500
Report of Security Violation
- Agency
- GSA
- Revision
- Rev. 7/1960
- Fillable fields
- 11
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 1500: Report of Security Violation
GSA Form 1500, Report of Security Violation, is a one-page General Services Administration (GSA) form, printed as GSA 1500 7/1960. GSA hosts it in its forms library, and GSA's page lists no authority or regulation for it.
The form records a violation of the regulations pertaining to the safeguarding of classified defense information. Section I, Violation, is executed by the Document Security Officer and gives the name, title and duty station of the violator and the nature of the violation. Section II, Explanation of Person Responsible for Violation, holds the violator's statement, signature and date. A Locale box at the top is checked Regional or Central Office.
The form says each section is executed in duplicate and the completed original is forwarded to the GSA Security Officer. It prints no OMB number, Privacy Act statement or time estimate. You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 1500
Instructions
Four numbered instructions on who executes each section, where the completed original goes and when, and the use of reverse or additional sheets.
Section I: the violator
Blocks for the name of the violator and the title and duty station of the violator.
Section I: nature of violation
A large block for the circumstances and facts, including time, date and place, the classified documents compromised or mishandled and their agency of origin, the actions or negligence of the person involved, and the action taken to prevent such violation in the future.
Section I: officer's signature
Signature of the Document Security Officer, official title and date.
Section II: statement of violator
A large block headed Statement of Violator, followed by a signature and date at the bottom of the page.
How to complete GSA Form 1500
- 1
Check the locale
Mark Regional or Central Office in the Locale box at the top right.
- 2
Identify the violator
In Section I, enter the name of the violator and the violator's title and duty station.
- 3
Describe the violation
The Nature of Violation block asks for time, date and place, the classified documents compromised or mishandled, the agency of origin, the actions or negligence involved, and the action taken to prevent such violation in the future.
- 4
Sign Section I
The Document Security Officer signs and enters an official title and the date.
- 5
Add the violator's statement
Section II holds the statement of the person responsible, with a signature and date. The form says to use reverse or additional sheets to continue explanations, if necessary.
- 6
Forward the original
The form says the completed original is forwarded to the GSA Security Officer "not later then one full working day after a security violation occurs or is reported to the Document Security Officer."
Why fill Form GSA1500 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the GSA, not a copy someone retyped
- Works on a phone, tablet or computer
Submission and records
Where it goes
The form says the completed original is forwarded to the GSA Security Officer. It prints no address.
Time stated on the form
In the form's own words, the original is forwarded "not later then one full working day after a security violation occurs or is reported to the Document Security Officer."
Copies
The form says Section I and Section II are each executed in duplicate.
What GSA's page says
GSA's page lists form number GSA1500 and a current revision date of 07/1960, with no authority or regulation given.
Privacy and time estimate
The form prints no Privacy Act statement, OMB number or time estimate.
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SF701
Activity Security Checklist
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SF702
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GSA3162
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Who fills out GSA Form 1500?
The instructions at the top of the form split the work between two people and name the officer who receives it.
Official sources and the blank
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Questions about Form GSA1500
Who issues GSA Form 1500?
The footer reads GENERAL SERVICES ADMINISTRATION and GSA 1500 7/1960. GSA hosts it in its forms library.
Who fills in each section?
The form says Section I is executed in duplicate by the Document Security Officer, and Section II in duplicate by the person responsible for the violation.
Where does the completed form go?
The form says the completed original is forwarded to the GSA Security Officer. It prints no address.
How soon is the original forwarded?
The form says "not later then one full working day after a security violation occurs or is reported to the Document Security Officer."
What if the explanation does not fit?
The form says to use reverse or additional sheets to continue explanations, if necessary.
Does GSA Form 1500 have an OMB number?
No. The form prints no OMB number, Privacy Act statement or time estimate.