Items 1 to 4: agency and billing details
The agency address (department, bureau and complete mailing address including ZIP Code), BOAC No., statement No. and quarter of billing.
GSA2992
Adjustment Voucher for Standard Level User Charge Transaction
- Agency
- GSA
- Revision
- Rev. 5/1982
- Fillable fields
- 28
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 2992: Adjustment Voucher for Standard Level User Charge Transaction
GSA Form 2992, Adjustment Voucher for Standard Level User Charge Transaction, is a General Services Administration form, Rev. 5/1982 (printed REV. 5-82), and GSA hosts it in its forms library. GSA's page lists the authority or regulation as FBF Handbook.
The heading says the form is for use by NON-SIBAC only and is completed in duplicate by a GSA customer agency whenever it declines to pay its Federal Building Fund SLUC bill. The one-page voucher is addressed to GSA's Office of Finance in Fort Worth, TX. It asks for the agency's billing details, the amount of the bill as shown on GSA Form 789, up to three adjustments by building and assignment with an explanation for each, the total amount of nonpayment and a certifying official. It prints no OMB number or privacy statement.
You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 2992
Item 5: amount of bill
The amount of the bill, as shown on GSA Form 789.
TO block and data note
The GSA Office of Finance address, with a note that all of the data to be filled in above may be found in the detailed portion of the SLUC bill.
Item 6: adjustment by building and assignment
Three entries, a to c, each with (1) agency/bureau code, (2) building number, (3) city, (4) state, (5) amount of nonpayment and (6) explanation.
Item 7: total amount of nonpayment
One dollar box for the total amount of nonpayment.
Item 8: certifying official
A. agency contact, B. date, C. typed name and address and D. telephone number (include area code).
How to complete GSA Form 2992
- 1
Copy the details from the SLUC bill
Fill in items 1 to 4. The form says all of the data to be filled in above may be found in the detailed portion of the SLUC bill.
- 2
Enter the amount of the bill
Enter the amount in item 5 as shown on GSA Form 789.
- 3
List each adjustment
For each building and assignment, enter the agency/bureau code, building number, city, state, amount of nonpayment and an explanation in item 6, entries a to c.
- 4
Total the nonpayment
Enter the total amount of nonpayment in item 7.
- 5
Complete the certifying official block
Fill in the agency contact, date, typed name and address, and telephone number with area code in item 8.
- 6
Complete it in duplicate
The form says it is completed in duplicate. The TO block names the GSA Office of Finance in Fort Worth.
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Routing and what the form says
Where it goes
The TO block reads General Services Administration, Office of Finance - 7BC, 819 Taylor Street, Fort Worth, TX 76102.
Copies
The form says it is completed in duplicate by the GSA customer agency.
Authority and edition
GSA's page lists the authority or regulation as FBF Handbook and a current revision date of 05/1982. The footer reads GSA FORM 2992 (REV. 5-82).
What the form does not print
It prints no instructions beyond the heading note, no deadline, no OMB number and no privacy statement.
Related forms
Who fills out GSA Form 2992?
The heading of the form says who completes it and when. Its blocks show who certifies it and where it goes.
Official sources and the blank
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Questions about Form GSA2992
Who issues GSA Form 2992?
The footer reads GENERAL SERVICES ADMINISTRATION and GSA FORM 2992 (REV. 5-82). GSA hosts it in its forms library.
When is GSA Form 2992 used?
The form says it is completed in duplicate by a GSA customer agency whenever it declines to pay its Federal Building Fund SLUC bill. The heading says it is for use by NON-SIBAC only.
Where does the information come from?
The form says all of the data to be filled in above may be found in the detailed portion of the SLUC bill. Item 5 asks for the amount of the bill as shown on GSA Form 789.
Where is GSA Form 2992 sent?
The TO block reads General Services Administration, Office of Finance - 7BC, 819 Taylor Street, Fort Worth, TX 76102.
How many adjustments fit on the form?
Item 6 prints three entries, a, b and c, each with its own building details, amount of nonpayment and explanation. The form does not mention continuation sheets.