Agency and lease
Agency, from GSA Form 65, Space Assignment Record, and lease number, from GSA Form 620, Lease Digest.
GSA1626
Record of Expenditures (Economy Act Limitation)
GSA Form 1626, Record of Expenditures (Economy Act Limitation), is a General Services Administration form, Rev. 6/1960 (the footer prints GSA FORM 1626 (6-60)), and GSA hosts it in its forms library. GSA's page lists no authority or regulation.
The one-page form is a ledger for one building. Its header takes the agency from GSA Form 65, Space Assignment Record, the lease number from GSA Form 620, Lease Digest, the building name and address, the annual net rent and a 25% limitation. Each line records a date, a contract order or other authorization number, a description of the work, the cost split into temporary and permanent, an adjustment plus or minus, and the balance available. The form says temporary costs are those excluded from limitation and permanent costs are those included in limitation. It prints no signature line, OMB number or privacy statement, and it does not say who keeps it.
You can fill it out free in your browser on this page and download the result without an account.

Agency, from GSA Form 65, Space Assignment Record, and lease number, from GSA Form 620, Lease Digest.
Building name and address, annual net rent and a 25% Limitation box.
A date and a contract order or other authorization number for each line.
The form says to identify each item in sufficient detail to readily determine application of Economy Limitation.
Two cost columns. The form says temporary costs are excluded from limitation and permanent costs are included in limitation.
An adjustment column marked + or - and a balance available column.
Copy the agency from GSA Form 65 and the lease number from GSA Form 620, as the labels say, then the building name and address.
Enter the annual net rent and the figure for the 25% Limitation box.
For each line, enter the date and the contract order or other authorization number.
The form says to identify each item in sufficient detail to readily determine application of Economy Limitation.
Put the cost under temporary or permanent. The form says temporary costs are excluded from limitation and permanent costs are included.
Enter any adjustment, plus or minus, and the balance available. The form says to enter E for estimated and A for actual.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
The PDF prints no address, routing or signature line, and it does not say who keeps the record.
GSA's page lists no authority or regulation, and the PDF prints none.
GSA Form 65, Space Assignment Record, and GSA Form 620, Lease Digest, are named in its header boxes.
The footer prints GSA FORM 1626 (6-60), and GSA's page gives the current revision date as 06/1960.
The Agency box says to take it from GSA Form 65, Space Assignment Record.
The Lease No. box says to take the number from GSA Form 620, Lease Digest. The header also holds the building name and address and the annual net rent.
Each line names a contract order or other authorization number for the work it records.
The form says to enter E for estimated and A for actual in the cost and balance available columns.
The form does not name the office that keeps it, and it has no signature line. Its headings point to these records and entries.
The agency’s own page for Form GSA1626.
The official blank form, to print or fill by hand.
No tool matches that search.
It is a General Services Administration form, and GSA hosts it in its forms library. GSA's page lists no authority or regulation.
The form says temporary costs are those excluded from limitation and permanent costs are those included in limitation.
The form says to enter E for estimated and A for actual in the cost and balance available columns.
The labels say the agency comes from GSA Form 65, Space Assignment Record, and the lease number from GSA Form 620, Lease Digest.
The form says to identify each item in sufficient detail to readily determine application of Economy Limitation.
No. It prints a 25% Limitation box next to the annual net rent but gives no instructions or legal citation for it.