Blocks 1 to 3: agency contact data
Department or agency, bureau, office or service, and the contact's name, title, phone and fax.
GSA3641
Senior Federal Travel
- Agency
- GSA
- Revision
- Rev. 8/1995
- Fillable fields
- 157
- Pages
- 2
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 3641: Senior Federal Travel Form
GSA Form 3641, Senior Federal Travel Form, is a General Services Administration form. Its footer reads GSA FORM 3641 (8-95), and its header prints Interagency Report Control Form 0322-GSA-AN. GSA's forms page lists it as Senior Federal Travel, with the authority or regulation OMB CIR. A-126, and GSA hosts it in its forms library.
The front page reports a flight dispatched by a federal department or agency: the agency contact, the aircraft, up to nine flight legs with dates and times, and each passenger's agency, status code, purpose of travel, legs flown, costs and any reimbursement amount. The back page holds the instructions for each block, including one-letter traveler status codes and two-character purpose of travel codes.
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What's on GSA Form 3641
Blocks 4 to 10: aircraft data
Registration number, serial number, make and model, purpose of flight (M, R or T), flight number, variable cost per hour and charter quote.
Blocks 11 to 13: flight legs and dates
Up to nine departure and arrival legs, each with a location (printed as Icao), date and time, plus hours and number of passengers per leg.
Blocks 14 to 18: passenger data
Passenger name, department or agency, status code, purpose of travel code, and the legs the passenger got on and off.
Blocks 19 and 20: costs and reimbursement
Government cost, charter cost and commercial carrier cost for each passenger, and any reimbursement amount.
Back page: instructions and codes
A definition for every block, the status codes and the purpose of travel codes.
How to complete GSA Form 3641
- 1
Enter the agency contact
Fill in blocks 1 to 3 for the dispatching agency and the person scheduling the flight.
- 2
Describe the aircraft and purpose
Block 7 takes M for agency mission, R for required use or T for other official travel, as defined on the back.
- 3
Log each leg
The instructions say dates are month-day-year and times are in 24-hour format, for each departure and arrival.
- 4
List each passenger
Enter the name last name first, the department or agency, the one-letter status code and the two-character purpose of travel code.
- 5
Enter the costs
19a is the traveler's share of the full operating cost, 19b the share of an FAA approved charter quote, and 19c the commercial cost had the traveler used scheduled airline service.
- 6
Show any reimbursement
Block 20 is the amount required to be reimbursed to the Government for the flight, if applicable.
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Routing and what the form says
Where it goes
The form prints no routing address. Its header reads Interagency Report Control Form 0322-GSA-AN.
Authority listed by GSA
GSA's forms page lists the authority or regulation as OMB CIR. A-126 and a current revision date of 08/1995.
Optional blocks
The instructions mark the serial number as optional, and the flight number, variable cost per hour, hours and passenger count as optional fields supporting the automated calculations in block 19.
Purpose of travel categories
Mission Requirement (1E, 1O, 1T), Required Use (2B, 2C, 2W), Other Official Travel (3B, 3C) and Space Available (4S).
Related forms
Who fills out GSA Form 3641?
The instructions on the back describe the agency contact and the travelers being reported. The form does not say where it is sent.
Official sources and the blank
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Questions about Form GSA3641
What do the passenger status codes mean?
C Contractor, N Non-Federal official, D Dependent, O Other Official Traveler (employee), E Senior Executive Branch official, S Senior Federal official and M Military.
What are the purpose of travel codes?
Two-character codes in four groups: Mission Requirement 1E, 1O and 1T; Required Use 2B, 2C and 2W; Other Official Travel 3B and 3C; and Space Available 4S. The form marks 2C, 2W, 3C and 4S as reimbursable categories.
Which blocks are optional?
The instructions mark the serial number as optional, and blocks 8, 9, 12 and 13 as optional fields supporting the automated calculations in block 19.
What costs does block 19 compare?
The government cost share of the aircraft's full operating cost, the share of a charter quote from an FAA approved vendor, and the commercial cost of scheduled airline service.
Where is GSA Form 3641 sent?
The form prints no address. Its header reads Interagency Report Control Form 0322-GSA-AN.