GSA2543A

Network Protector Test Record

Agency
GSA
Revision
Rev. 1/1970
Fillable fields
47
Pages
1
Official source
GSA form page
Checked
October 20, 2026
Fill GSA2543A online
Page 1 of form GSA2543A

GSA Form 2543A: Network Protector Test Record

GSA Form 2543A, Network Protector Test Record, is a one-page General Services Administration record. The footer reads GSA FORM 2543A (1-70), and GSA hosts it in its forms library. GSA's page lists a current revision date of 01/1970 and no authority or regulation.

The form records one test of a network protector: whether it was a schedule test, a new installation or special, the field office, building and location and circuit designation, then the protector's capacity in amps with 216 Volt and 480 Volt boxes, serial, type and operations counter. It logs minimum pick up volts, trip coil and motor relay readings, a resistance block, the fuse and auxiliary timing, and a relays section for the master, close, phasing and time delay relays.

The form ends with remarks and the analyst's name and date. It prints no instructions and does not spell out its abbreviations. You can fill it out free in your browser on this page and download the result without an account.

Top of page 1 of GSA Form 2543A: Network Protector Test Record, as printed by GSA

What's on GSA Form 2543A

Test type and location

Check boxes for schedule, new installation or special, then field office, building and location, and circuit designation.

Protector details

Capacity in amps with 216 Volt and 480 Volt check boxes, serial, type, and the operations counter under AF and AL.

Pick up, trip coil and resistance

Minimum pick up volts, trip coil and motor relay under AF and AL, a resistance block (printed CONTRACT RESISTANCE) under AO, BO and CO with wipe, the fuse and aux contract timing.

Relays: master, close and phasing

Type, serial, voltage and test voltage for the master relay, close readings under AF and AL, and type, serial, voltage and res tap for the phasing relay.

Relays: close and time delay

Type, serial and open torque for a second close row, then type, serial, INST, AO, BO and CO amps and delay in seconds for the time delay relay.

Remarks, analyst and date

A remarks area, the analyst's name and the date.

How to complete GSA Form 2543A

  1. 1

    Mark the test type

    Check schedule, new installation or special.

  2. 2

    Identify the location and circuit

    Enter the field office, the building and location, and the circuit designation.

  3. 3

    Describe the protector

    Enter the capacity in amps, check 216 Volt or 480 Volt, and enter the serial, type and operations counter readings.

  4. 4

    Log the readings

    Record minimum pick up volts, trip coil and motor relay values, the resistance and wipe values, the fuse and the aux contract timing.

  5. 5

    Record the relays

    Fill the master, close, phasing, second close and time delay relay rows.

  6. 6

    Add remarks and sign off

    Note any remarks, then enter the analyst's name and the date.

The form prints no instructions. These steps follow its blocks from top to bottom.

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Routing and what the form says

Where it goes

The form prints no address or routing. It names a field office at the top and an analyst at the foot.

Edition

The footer reads GSA FORM 2543A (1-70). GSA's page lists a current revision date of 01/1970 and no authority or regulation.

What the form does not print

No instructions, test limits, OMB number or privacy statement, and no explanation of AF, AL, AO, BO, CO, INST or RES TAP.

Related forms

Who uses GSA Form 2543A?

  • The analyst

    The ANALYST (Name) block and a DATE block at the foot of the form record who did the test and when. The form has no other signature block.

  • The field office

    The FIELD OFFICE block names the office the record belongs to, above the building and location.

  • Schedule tests

    A SCHEDULE check box is the first of three test types at the top of the form.

  • New installations and special tests

    Separate NEW INSTALLATION and SPECIAL check boxes sit beside SCHEDULE. The form says nothing more about when each applies.

The form names one role, the analyst. Its top blocks show where and why the test took place.

Official sources and the blank

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Questions about Form GSA2543A

Who issues GSA Form 2543A?

The footer reads GENERAL SERVICES ADMINISTRATION and GSA FORM 2543A (1-70). GSA hosts it in its forms library, and its page lists no authority or regulation.

Who completes GSA Form 2543A?

The form has one person block, ANALYST (Name), with a date beside it. It does not say who the analyst works for beyond the field office named at the top.

Which voltages does the form list?

The protector section has two check boxes, 216 Volt and 480 Volt, beside the capacity in amps.

Which relays does the form cover?

The relays section has rows headed MASTER, CLOSE, PHASING, a second CLOSE and TIME DELAY.

Does GSA Form 2543A give test limits?

No. It has blank fields for readings in volts, amps and seconds but prints no limits, settings or instructions.