Payment notice
The accepted cards (American Express, Discover, MasterCard and VISA) and the email, fax and mailing address the completed form goes to.
GSA3602B
Credit Card Collection
- Agency
- GSA
- Revision
- Rev. 10/2020
- Fillable fields
- 21
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 3602B: Credit Card Collection
GSA Form 3602B, Credit Card Collection, is a one-page GSA form. The footer reads GENERAL SERVICES ADMINISTRATION and GSA 3602B (REV. 10/2020), and GSA's page lists CFO 4253.1C as its authority. GSA hosts it in its forms library.
The top of the form is addressed to U.S. General Services Administration customers and debtors. It says GSA will now accept American Express, Discover, MasterCard, and VISA for settlement of outstanding bills, claims or debts. The form itself records the claim, bill, project or contract number (or Standard Carrier Alpha Code), the amount, the cardholder's billing address and card details, and an authorization for GSA to charge the card for the amount shown upon receipt. A short Privacy Act statement is printed on the form.
You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 3602B
Privacy Act statement
The form says information provided in connection with payment by credit card will be used solely to effect payment through the appropriate banking or other financial institutions.
Authorization and payment line
The authorization to charge the card for the amount shown on the claim number upon receipt, then the reference number, amount in dollars, business line, payment type and agency name.
Cardholder information
Billing address, state, ZIP code and country, a check box for the card type, the credit card number and the expiration date.
Name, phone and signature
The card holder's name as it appears on the credit card, a telephone number, the authorized signature and the date. The signature box also prints the words BY PHONE.
The form is one page with these blocks.
How to complete GSA Form 3602B
- 1
Enter the reference number
Write the claim number, bill number, project number, contract number or SCAC that identifies the bill, claim or debt being paid.
- 2
Enter the amount and business line
Fill in the amount next to the printed $ sign and the business line. Payment type and agency name are already printed.
- 3
Add the card details
Give the billing address, state, ZIP code and country, check the card type, and enter the credit card number and expiration date.
- 4
Print your name and phone number
Print the card holder's name as it appears on the credit card and add a telephone number.
- 5
Sign and date
Sign the authorized signature box and date it. The signed form authorizes GSA to charge the card for the amount shown upon receipt.
- 6
Send the completed form
The form says to send it by email, by fax or to the mailing address printed at the top.
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Where it goes and what the form says
By email
The form says to send the completed form to [email protected].
By fax
Fax to (816) 823-1048, as printed on the form.
By mail
USDA - OCFO, Financial Information & Operations Division, Financial Information Control Branch, 2300 Main Street - 2SE, Kansas City, MO 64108.
Authority
GSA's page lists CFO 4253.1C as the authority or regulation for the form, with a current revision date of 10/2020.
Privacy
The Privacy Act statement says the card information will be used solely to effect payment through the appropriate banking or other financial institutions.
Related forms
Who fills out GSA Form 3602B?
The form is addressed to GSA customers and debtors and is completed by the person whose card is charged.
Official sources and the blank
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Questions about Form GSA3602B
Who issues GSA Form 3602B?
It is a GSA form. The footer reads GENERAL SERVICES ADMINISTRATION and GSA 3602B (REV. 10/2020), and GSA's page lists CFO 4253.1C as its authority.
Which credit cards does the form list?
American Express, Discover, MasterCard and VISA. The form has a check box for each.
What can be paid with GSA Form 3602B?
The form says GSA accepts these cards for settlement of outstanding bills, claims or debts. The payment line identifies the item by claim, bill, project or contract number, or by Standard Carrier Alpha Code (SCAC).
Where do I send the completed form?
The form lists three ways: email to [email protected], fax to (816) 823-1048, or mail to USDA - OCFO, Financial Information & Operations Division, Financial Information Control Branch, in Kansas City, MO 64108.
When is the card charged?
The authorization printed on the form says GSA may charge the credit card for the amount shown on the claim number upon receipt.
How is the card information used?
The Privacy Act statement says it will be used solely to effect payment through the appropriate banking or other financial institutions.