Instructions to employee
Point to SF 1012 for the total and list four documents to include. The form says failure to supply them could result in a delay in reimbursement.
GSA2494A
Claim for Reimbursement of Closing Costs for Purchase of New Residence
- Agency
- GSA
- Revision
- Rev. 10/1989
- Fillable fields
- 233
- Pages
- 4
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 2494-A: Claim for Reimbursement of Closing Costs for Purchase of New Residence
GSA Form 2494-A, Claim for Reimbursement of Closing Costs for Purchase of New Residence, is a General Services Administration form. Its footer reads GSA FORM 2494-A (REV. 10-89), and GSA hosts it in its forms library. GSA's page lists PFM P 4290.1 as its authority or regulation, and the form's Privacy Act statement cites 5 USC 5701-5733, particularly sections 5721-5733, 30 USC 905 and Executive Order 9397.
The employee completes it to claim the closing costs of buying the new residence. The Privacy Act statement says the data is used to determine eligibility for and the amount of reimbursement for expenses incurred in connection with permanent change of station travel. The instructions to employee say the total amount claimed for the purchase must be included on a separate SF 1012, Travel Voucher, and list four documents to include.
The PDF has four copies of the same page: Copy 1 Attach to SF 1012, Travel Voucher; Copy 2 Employee Copy; Copy 3 Real Estate Approving Official Copy; and Copy 4 Executive Office Copy. You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 2494-A
Section A: employee and residence
Employee name, travel authorization number, old and new official stations, date notified of impending transfer, reporting date, date of closing or settlement, new residence address and type of property.
Section B: closing costs claimed
Item 10, lines a to r: loan origination fee with a percent, appraisal fee, credit report, lender's inspection, assumption, settlement, title and document fees, notary, attorney's fee, title insurance, recording fees, tax or stamps, survey and up to five other costs, with a total.
Section C: employee certification
The employee certifies the amounts were actually paid by them and that title is ONLY in their name and/or a member of their immediate family and is their new residence, then signs and dates.
Sections D and E: approvals
Purchase approval as claimed or as reduced per attached letter, and final administrative approval for payment in a stated amount, each with signature, name, title and date.
Privacy Act of 1974
Cites the authority, says disclosure is voluntary and gives the purpose, routine transfers and the effect of not furnishing the information.
How to complete GSA Form 2494-A
- 1
Gather the documents
The form lists the purchase contract and any addenda signed by both sellers and buyers, the closing statement signed by both or certified by the settlement agent, the Truth-in-Lending statement if new financing was obtained, and receipts or canceled checks for items paid outside of closing (POC).
- 2
Complete Section A
Enter the employee name, travel authorization number, old and new official stations, the date notified of the transfer, reporting date, closing date, the new residence address and the type of property.
- 3
Enter the closing costs
The Section B note says to enter the amount actually paid on the appropriate line. Lines b and c say to enclose a receipt or canceled check. Use lines (1) to (5) for other closing costs, then enter the total.
- 4
Check the title insurance line
Line m says only the lender's portion of a title insurance policy is reimbursable, and that the settlement agent can provide the proration when lender's and owner's coverage were bought together.
- 5
Sign the certification
The employee signs and dates Section C. Sections D and E then take the approval signatures, names, titles and dates.
- 6
Claim the total on SF 1012
The instructions say the total amount claimed must be included on a separate SF 1012, Travel Voucher, and Copy 1 is marked to attach to it.
Why fill Form GSA2494A on indox
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What the form says
Where the copies go
The form prints no address. Copy 1 is marked Attach to SF 1012, Travel Voucher, Copy 2 Employee Copy, Copy 3 Real Estate Approving Official Copy and Copy 4 Executive Office Copy.
Missing documents
The instructions say failure to supply the required documentation could result in a delay in reimbursement.
What is reimbursed
The Section B note says allowable costs incurred that are reasonable in amount and customarily paid by the purchaser of a residence in the locality are reimbursed.
Privacy
The form says disclosure is voluntary, but without the information it will not be able to reimburse the expenses. Information may be transferred to Federal, State or local agencies when relevant to civil, criminal or regulatory investigations or prosecutions.
Edition and authority
The footer reads GSA FORM 2494-A (REV. 10-89). GSA's page gives a current revision date of 10/1989 and lists PFM P 4290.1 as the authority or regulation.
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Who fills out GSA Form 2494-A?
The form is addressed to the employee, and its four copies are marked for the people and offices that receive them.
Official sources and the blank
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Questions about Form GSA2494A
Who issues GSA Form 2494-A?
The footer names the General Services Administration and reads GSA FORM 2494-A (REV. 10-89). GSA hosts it in its forms library, and its page lists PFM P 4290.1 as the authority or regulation.
How is GSA Form 2494-A different from GSA Form 2494?
GSA Form 2494-A claims closing costs for the purchase of a new residence, and GSA Form 2494 claims closing costs for the sale of the old residence. Their cost lines and approval wording differ.
Does GSA Form 2494-A replace the travel voucher?
No. The instructions say the total amount of expenses claimed for the purchase must be included on a separate SF 1012, Travel Voucher, and Copy 1 is marked to attach to it.
What documents go with the claim?
The purchase contract and any addenda signed by both sellers and buyers, the closing statement signed by both or certified by the settlement agent, the Truth-in-Lending statement if new financing was obtained, and receipts or canceled checks for items paid outside of closing.
What does the form say about title insurance?
Line m says only the lender's portion of a title insurance policy is reimbursable, and that if both lender's and owner's coverage were bought together, the settlement agent should provide the proper proration of the cost.
Can the approved amount differ from the claim?
Section D has an As Reduced per Attached Letter box next to As Claimed, and Section E states the amount approved for payment.
Why does the PDF have four pages?
It holds four copies of the same form, marked Copy 1 Attach to SF 1012, Travel Voucher, Copy 2 Employee Copy, Copy 3 Real Estate Approving Official Copy and Copy 4 Executive Office Copy.