Header: vacancy and applicant
Announcement number, position and name of applicant, beside the instructions for the applicant and the supervisor.
GSA3413
Supervisory Appraisal of Demonstrated Performance or Potential
- Agency
- GSA
- Revision
- Rev. 10/1984
- Fillable fields
- 77
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 3413: Supervisory Appraisal of Demonstrated Performance or Potential
GSA Form 3413, Supervisory Appraisal of Demonstrated Performance or Potential, is a General Services Administration form, GSA FORM 3413 (REV. 10-84), hosted in GSA's forms library. A supervisor rates an applicant for a position named by announcement number and position title.
The form's instructions say: Please have this appraisal completed by your supervisor and submit it with your application (SF 171). They add that if the appraisal is submitted directly by the supervisor, the applicant will be permitted to review and/or obtain a copy of the appraisal request, and tell the supervisor to take into consideration the employee's annual performance appraisal when completing this form.
Section I rates ranking factors (knowledge, skills, abilities, and other characteristics) on a scale from 4 - Superior to 0 - Not Observed. Section II is a narrative statement, followed by the appraiser's capacity, the period of supervision and two signature lines. 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 3413
Section I: basis for appraisal
For each ranking factor, one basis is checked: Outside Activities, On the Job Performance, Formal Training or Potential.
Section I: ranking factors and level
Six rows for ranking factors (knowledge, skills, abilities, and other characteristics), each with one level checked: 4 - Superior, 3 - Above Average, 2 - Average, 1 - Developmental or 0 - Not Observed.
Section II: narrative statement
A box to briefly evaluate the candidate's overall ability to perform the duties and responsibilities of the position.
Appraiser and signatures
The capacity of the appraiser, the period during which the appraiser supervised the applicant (from and to), and the supervisor's and employee's signatures with dates.
How to complete GSA Form 3413
- 1
Enter the vacancy and applicant
Fill in the announcement number, the position and the name of the applicant at the top of the form.
- 2
List and rate each ranking factor
Write each ranking factor in Section I, check the basis for the appraisal and check one level of performance from 4 to 0.
- 3
Write the narrative
The form says narrative comments are required for all factors, and that the reverse side may be used if additional space is needed.
- 4
Show the appraiser's capacity
Check one capacity box, or Other with a description, and enter the from and to dates of the period of supervision.
- 5
Sign and date
The supervisor signs and adds the date and a telephone number. The employee's signature and date line follows.
Why fill Form GSA3413 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the GSA, not a copy someone retyped
- Works on a phone, tablet or computer
Where it goes and what the form says
Submitted with the application
The form's instructions say to submit the appraisal with your application (SF 171). It prints no mailing address.
Submitted by the supervisor
The form says that if the appraisal is submitted directly by the supervisor, the applicant will be permitted to review and/or obtain a copy of the appraisal request.
Annual performance appraisal
The supervisor is told to take into consideration the employee's annual performance appraisal when completing this form.
What the form does not print
No OMB number, privacy statement, authority or deadline appears on the form, and GSA's page lists no authority or regulation.
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GSA3410
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Who fills out GSA Form 3413?
The instructions in the header and the signature blocks at the bottom show these roles.
Official sources and the blank
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Questions about Form GSA3413
Who issues GSA Form 3413?
The footer reads GENERAL SERVICES ADMINISTRATION and GSA FORM 3413 (REV. 10-84). GSA hosts it in its forms library.
Who fills out GSA Form 3413?
The applicant's supervisor. The instructions ask the applicant to have the appraisal completed by their supervisor, and the appraiser checks a capacity such as present immediate supervisor or former 2nd level supervisor.
What do the levels 4 to 0 mean?
The form prints 4 - Superior, 3 - Above Average, 2 - Average, 1 - Developmental and 0 - Not Observed. One level is checked for each ranking factor.
Is the narrative statement optional?
The form says narrative comments are required for all factors. If additional space is needed, it says to use the reverse side.
Can the applicant see the appraisal?
The form says that if the appraisal is submitted directly by the supervisor, the applicant will be permitted to review and/or obtain a copy of the appraisal request.
What application does the form mention?
The instructions say to submit the appraisal with your application (SF 171).