Privacy Act and background
The authority for the information, its purpose and the system notice, then a background note on the rules in 26 C.F.R. Parts 1 and 602 for qualified transportation fringe benefits.
GSA3667
Application for Pretax Transportation Fringe Benefits
- Agency
- GSA
- Revision
- Rev. 11/2025
- Fillable fields
- 17
- Pages
- 2
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 3667: Application for Pretax Transportation Fringe Benefits
GSA Form 3667, Application for Pretax Transportation Fringe Benefits, is a two-page GSA form marked CUI when filled in. The footer reads GENERAL SERVICES ADMINISTRATION and GSA 3667 (REV. 11/2025), and GSA hosts it in its forms library.
The instructions say the Transportation Equity Act of the 21st Century (TEA-21) benefit program is a provision of the Internal Revenue Code (26 U.S.C. 132) that permits an employer to pay for an employee's cost of commuting to work in other than a single occupancy vehicle, offered to employees as a pretax payroll deduction. The form has three numbered sections: employee information, type of benefit (commuter highway vehicle, transit pass, qualified parking or cancellation, with a monthly pretax amount requested) and an employee certification. A note says recertification is required by December 15th of each year, or when an employee's circumstances change.
You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 3667
Section 1: employee information
Name (last, first, middle initial), filing date, effective month, region and agency.
Section 2a: commuter highway vehicle
Up to $340.00 monthly. The form says the vehicle seats at least six (6) adults, not including the driver, and at least 80 percent of the mileage is for taking employees between home and work.
Sections 2b and 2c: transit pass and parking
Transit pass, up to $340.00 monthly, allowed only when the agency doesn't provide mass transit passes. Qualified parking, up to $340.00 monthly, which the form says excludes parking on or near property used for residential purposes.
Section 2d: cancellation
A box to cancel the benefit, with an effective month.
Section 3: certification
The employee certifies eligibility under 26 U.S.C. 132, use only for the regular daily direct commute, no transfer to anyone else, and a benefit no higher than the average monthly commuting cost based on a 20-day month, then signs and dates.
How to complete GSA Form 3667
- 1
Fill in Section 1
Enter the name, filing date, effective month, region and agency.
- 2
Check one type of benefit
The instructions say to check the appropriate box in Section 2. Enter the monthly pretax amount requested beside it.
- 3
Or check cancellation
The instructions say box 2d is used only when cancelling, with the effective month entered.
- 4
Read and sign the certification
The instructions say to read Section 3 carefully, then sign and date the form.
- 5
Fax it to the GSA PSB
The instructions give GSA PSB, Customer Service fax numbers (816) 823-5435 (primary) and (816) 823-5533 (alternate).
- 6
Recertify each year
The form says recertification is required by December 15th of each year, or when an employee's circumstances change.
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Where it goes and what the form says
Where it goes
The instructions say the form may be faxed to the GSA PSB, Customer Service at (816) 823-5435 (primary) or (816) 823-5533 (alternate).
When benefits start
The form says benefits will be activated the month following the receipt of the election form.
Monthly amounts printed
Section 2 shows up to $340.00 monthly for each type of benefit. The instructions say the tax year 2026 monthly benefit is $340 for vanpools, transit passes and qualified parking, and that all benefits are indexed for inflation.
Effect on pay
The instructions say the decision to receive the benefit will not affect the employee's basic rate of pay, citing 5 C.F.R. § 550.103.
Privacy
The Privacy Act statement says disclosure is voluntary, but expenses will not be reimbursed without the information. It names GSA Privacy Act System Notice GSA/-Transit-1 (Transportation Benefits Records).
False certification
The certification says false certification may result in disciplinary action by the U.S. General Services Administration up to and including dismissal from Federal employment and possible prosecution for Federal income tax evasion.
Related forms
Who fills out GSA Form 3667?
The employee completes and signs the form. Its instructions name the office that receives it.
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Questions about Form GSA3667
Who issues GSA Form 3667?
The footer reads GENERAL SERVICES ADMINISTRATION and GSA 3667 (REV. 11/2025). GSA hosts it in its forms library, and the form's background section cites 26 C.F.R. Parts 1 and 602.
What monthly amounts does the form print?
Section 2 shows up to $340.00 monthly for a commuter highway vehicle, a transit pass and qualified parking. The instructions say the tax year 2026 monthly benefit is $340 for each.
Where do I send GSA Form 3667?
The instructions say it may be faxed to the GSA PSB, Customer Service at (816) 823-5435 (primary) or (816) 823-5533 (alternate).
When does the benefit start?
The form says benefits will be activated the month following the receipt of the election form.
How often is the form renewed?
The form says recertification is required by December 15th of each year, or when an employee's circumstances change.
What does the form say about transit passes?
Box 2b says the transit pass benefit is allowed only when the agency doesn't provide mass transit passes, and defines a transit pass as any pass, token, fare card, voucher, or similar item for mass transit.
Does the benefit change the employee's pay rate?
The instructions say the decision to receive the transportation fringe benefit will not affect the employee's basic rate of pay, citing 5 C.F.R. § 550.103.