Items 1 to 3: administrative data
The report date, whether it is for CO or REGION, and the employee's name and Social Security number.
GSA2578
Report of Investigation of Claim for Waiver of Erroneous Payment of Pay and Allowances
- Agency
- GSA
- Revision
- Rev. 9/2016
- Fillable fields
- 302
- Pages
- 2
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 2578: Report of Investigation of Claim for Waiver of Erroneous Payment
GSA Form 2578, Report of Investigation of Claim for Waiver of Erroneous Payment of Pay and Allowances, is a General Services Administration (GSA) form, GSA 2578 (REV. 9/2016), printed with the citation 5 U.S.C. 5584 under its title. GSA's page lists the same authority or regulation, and GSA hosts it in its forms library. The form says to see CFO P 4253.1A for instructions on completing it, and its footer says Previous Editions are NOT usable.
The Privacy Act statement says the primary use of the information is by GSA personnel and payroll offices to document a claim for waiver of erroneous overpayment of pay and allowances under 5 U.S.C. 5584. The front records administrative data, overpayment information, eight waiver consideration questions answered in column A or B, and the final action with a signature. The back lists the erroneous payments by pay period.
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What's on GSA Form 2578
Item 4: overpayment information
The dates from and to (listed on the back by pay periods), the date of discovery and the gross amount in dollars.
Items 5 to 12: waiver considerations
Eight questions, such as whether the claim was sent to the Attorney General for litigation, whether the waiver request is within 3 years of the date of discovery, and whether the overpayment was the result of administrative error. Each is checked in column A or column B.
Items 13 and 14: final action
Waiver approved for the gross amount in item 4c, a partial waiver with approved and denied amounts and an attached explanation, or waiver denied completely, then a signature, date and title.
Back: listing of erroneous payments
For each pay period (a): the calculations (b), the actual erroneous payment (c), the recomputed correct pay (d), the overpayment (c) minus (d) in column (e), and collections (f), with totals and the uncollected overpayment.
Privacy Act statement
Printed at the bottom of the front, it gives the authority for collection, the uses of the information and the role of the Social Security number.
How to complete GSA Form 2578
- 1
Check the instructions
The form says to see CFO P 4253.1A for instructions on completing it. That document is not part of the PDF.
- 2
Fill in items 1 to 4
Enter the report date, CO or REGION, the employee's name and Social Security number, the overpayment dates, the date of discovery and the gross amount.
- 3
Answer items 5 to 12
Check column A or B for each question. The form says checks in column (A) may favor a recommendation to approve waiver or refunds, and checks in column (B) may favor a recommendation to deny waiver.
- 4
Attach the narrative findings
The form says items 7 thru 12 require a narrative description of findings in attachments.
- 5
List the payments on the back
Enter each pay period with columns (a) to (f), then the totals. The form says total column (e) minus total column (f) equals the uncollected overpayment.
- 6
Record the final action and sign
Complete item 13a, 13b or 13c, with an explanation attached for a partial waiver, then the signature, date and title in items 14a and 14b.
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Authority, privacy and what the form says
Authority
The form prints 5 U.S.C. 5584 under its title, and GSA's page lists the same authority or regulation.
Instructions and routing
The form says to see CFO P 4253.1A for instructions on completing it. The PDF does not include that document and gives no filing address.
Privacy
The Privacy Act statement cites Section 8311 of Title 5, U.S. Code, and Public Law 102-25. Other disclosures it lists include law enforcement agencies, a Federal agency investigating for employment or security reasons, OPM and the National Archives and Records Administration.
Social Security number
The statement says collection of the Social Security Number is authorized by Executive Order 9397, and that furnishing the information is voluntary, but failure to do so may jeopardize the request for a claim for waiver of overpayment of pay.
Edition
The footer reads GENERAL SERVICES ADMINISTRATION and GSA 2578 (REV. 9/2016), with the note Previous Editions are NOT usable.
Related forms
Who fills out GSA Form 2578?
The form points to CFO P 4253.1A for instructions and does not name the preparer by title. Its blocks and Privacy Act statement name these roles.
Official sources and the blank
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Questions about Form GSA2578
Who issues GSA Form 2578?
The footer reads GENERAL SERVICES ADMINISTRATION and GSA 2578 (REV. 9/2016). The form prints 5 U.S.C. 5584 under its title, and GSA hosts it in its forms library.
Who uses GSA Form 2578?
The Privacy Act statement says the primary use of the information is by GSA personnel and payroll offices to document an employee's claim for waiver of erroneous overpayment of pay and allowances.
Where are the instructions?
The form says to see CFO P 4253.1A for instructions on completing it. The PDF does not include that document.
What do columns A and B mean?
The form says checks in column (A) may favor a recommendation to approve waiver or refunds, and checks in column (B) may favor a recommendation to deny waiver.
What goes on the back of the form?
A listing of erroneous payments by pay period, with the calculations, the erroneous payment, the recomputed correct pay, the overpayment, collections, totals and the uncollected overpayment.
Is the Social Security number required?
The Privacy Act statement says furnishing the information, including the Social Security Number, is voluntary, but failure to do so may jeopardize the request for a claim for waiver of overpayment of pay.
Can an older edition be used?
The footer of the 9/2016 edition says Previous Editions are NOT usable.