Items 1 and 2: region and quarter
The region submitting the report and the applicable calendar quarter, shown as the quarter ending.
GSA2075
Quarterly Summary of Government Motor Vehicle Accidents
- Agency
- GSA
- Revision
- Rev. 1/1991
- Fillable fields
- 96
- Pages
- 2
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 2075: Quarterly Summary of Government Motor Vehicle Accidents
GSA Form 2075, Quarterly Summary of Government Motor Vehicle Accidents, is a General Services Administration form, Rev. 1/1991, with Reports Control Number PBS - 155. GSA hosts it in its forms library.
The form is an internal GSA report. A GSA region enters the miles driven by GSA employees in the quarter and lists each reportable government vehicle accident by report number, date and reason. The instructions on the back say the form is forwarded to the Safety and Environmental Management Division (PMS) within 10 calendar days following receipt of the Regional Quarterly Mileage Report, with Standard Forms 91 and 91A attached for each entry.
The form has eight numbered blocks on the front and item by item instructions on the reverse. You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 2075
Item 3: miles driven by GSA employees
Miles in general purpose vehicles such as sedans or station wagons (formerly identified as classes 11-23 and 51-52), miles in all other vehicles, and the total of 3A and 3B.
Item 4: summary of accidents
A table with the report number, the date of the accident and the reason for reporting it, one line per accident.
Items 5 to 8: preparer and approval
The name and title of the person who prepared the report, the date, the approving official's signature and the date.
Instructions on the reverse
Which accidents are reportable, which are not, where the form goes and when, and an instruction for each item.
How to complete GSA Form 2075
- 1
Check which accidents are reportable
The form says an accident is reported if it results in an injury to anyone which requires medical treatment, regardless of severity, or total property damage exceeding the criteria in the current edition of the GSA Handbook, PBS P 5900.2.
- 2
Enter the region, quarter and miles
Fill in items 1 and 2, then the miles driven by GSA employees in general purpose vehicles, in all other vehicles, and their sum in 3C.
- 3
Number each report
Starting October 1 of the current fiscal year, each report is numbered consecutively. The number goes in block 4A and at the top of the corresponding SF91/SF91A.
- 4
Give the date and reason
Enter the date of each accident in 4B and the reason for the report in 4C. The form's examples are damage exceeds reportable criteria, and vehicle occupant injury.
- 5
Attach SF 91 and SF 91A
The instructions say Standard Forms 91 and 91A must be attached to the report for each entry on the form.
- 6
Have it approved and forwarded
The approving official signs item 7, and the form goes to the Safety and Environmental Management Division (PMS) within 10 calendar days following receipt of the Regional Quarterly Mileage Report.
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Where it goes and what the form says
Where it goes
The Safety and Environmental Management Division (PMS). The form prints no mailing address.
Time stated on the form
Within 10 calendar days following receipt of the Regional Quarterly Mileage Report.
Parked vehicles
The form says a vehicle properly parked which is struck by a non-government motor vehicle is not considered a vehicle accident for this form. It says such an accident may be reportable under the current edition of PBS P 5900.2 as property damage or occupational injury.
Reports control number
The form carries Reports Control Number PBS - 155 in its top right corner.
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Who fills out GSA Form 2075?
The form and its instructions name these roles. It is not a form the public files.
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Questions about Form GSA2075
Who issues GSA Form 2075?
It is a General Services Administration form, Rev. 1/1991, with Reports Control Number PBS - 155. GSA hosts it in its forms library.
Which accidents go on GSA Form 2075?
The form says an accident is reported if it results in an injury to anyone which requires medical treatment, regardless of severity, or total property damage exceeding the criteria in the current edition of the GSA Handbook, PBS P 5900.2.
Is a parked vehicle that gets hit reported on it?
The form says a vehicle properly parked which is struck by a non-government motor vehicle is not considered a vehicle accident for this form, though it may be reportable under PBS P 5900.2 as property damage or occupational injury.
What goes with GSA Form 2075?
The instructions say Standard Forms 91 and 91A must be attached for each entry, with the report number from block 4A written at the top of the corresponding SF91/SF91A.
Who approves GSA Form 2075?
The instructions say the Safety and Environmental Management Division Director or Branch Chief, or higher, is considered the approving official, and the signature is required in item 7.
When is GSA Form 2075 due?
The form says it is forwarded to the Safety and Environmental Management Division (PMS) within 10 calendar days following receipt of the Regional Quarterly Mileage Report.