Section A: employee information
Items 1 to 4: name (last, first, middle initial), GSA Employee ID number, GSA email address, and a telephone number marked home or cell.
GSA3691
Student Loan Repayment Program - Loan Information and Verification
- Agency
- GSA
- Revision
- Rev. 3/2026
- Fillable fields
- 18
- Pages
- 2
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 3691: Student Loan Repayment Program (Loan Information and Verification)
GSA Form 3691, Student Loan Repayment Program (Loan Information and Verification), is a U.S. General Services Administration form. Its footer reads GENERAL SERVICES ADMINISTRATION, GSA 3691 3/2026, and GSA's page lists the authority as 5 U.S.C. § 5379. GSA hosts it in its forms library.
The form says to use it to assist the GSA Office of the Chief Financial Officer to verify student loan balance and process an electronic funds payment to the loan servicing institution. Sections A and B are prepared by the GSA employee. It is an internal GSA form, not one the public files.
The front page asks for the employee's details, the lender, the type of loan and current balances. The back page has instructions for each question, IRS 1099A instructions and a Privacy Act 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 3691
Section B: lender information
Items 5 to 8: the loan servicing institution's name, Tax Identification Number (TIN), mailing address and telephone number.
Item 9: type of loan
Lists Federal Family Education Loans (FFEL), William D. Ford Direct Loan Program loans, Federal Perkins Loan Program loans, and loans made or insured under the Public Health Service Act.
Item 10: balances
The loan balance verification date (MM/DD/YYYY) and the current balance and loan or account number for up to three loans to receive payment.
Back page: instructions
Instructions for questions 1 to 10, and IRS 1099A instructions in 11 numbered steps covering Sections 1 to 3 of that form.
Privacy Act Statement
The legal authority, who uses the information, where it is stored and what may happen if it is not provided.
How to complete GSA Form 3691
- 1
Complete Section A
Give your name as it is stored in agency records, your GSA Employee ID number from HR Links, your GSA email address and your most often used telephone number.
- 2
Add the lender in Section B
Enter the servicer's name, its Employer ID number, usually available on the Internet or from its customer service, its mailing address and its customer service telephone number.
- 3
Confirm the loan type
The instructions say to verify the exact type of loan with the servicer's customer service department, to make sure it is Federally-insured and a qualifying loan type.
- 4
Enter the balances and attach proof
Give the balances for the loans to be paid and the date each was verified online with the lender. The form says to staple a copy of the Internet printout showing this information.
- 5
Follow the IRS 1099A instructions
The back page lists 11 steps for Sections 1 to 3 of that form, including your social security number and signature, and the name, telephone number and signature of a representative of the financial institution.
These steps follow the instructions printed on the back of the form.
Why fill Form GSA3691 on indox
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Payment, contacts and privacy
How the payment is made
The form says it is used to process an electronic funds payment to the loan servicing institution. Question 7 says the servicer's mailing address will not be used to mail a check.
GSA fax and address printed on the form
The IRS 1099A instructions say to enter GSA Fax: (816) 823-5435 under Government Agency Name and 2300 Main Street - 2NW, Kansas City, Missouri 64108 under Government Agency Address in Section 2.
Authority
The Privacy Act Statement cites 5 U.S.C. § 3301 and 5 U.S.C. § 3302, and says the information also supports benefits decisions for student loan repayment under 5 U.S.C. § 5379.
Use and storage
The form says only the GSA Office of Chief Financial Officer uses the information, under 5 U.S.C. § 552a(b)(3). It is stored in OPM's eOPF under SORN OPM/GOVT-1, 77 FR 73694 (December 11, 2012).
If information is not provided
The form says disclosure is mandatory for benefits processing, and failure to provide it may lead to the erroneous payment or non-payment of eligible compensation and benefits.
Related forms
GSA3692
Student Loan Repayment Service Agreement
14 fields, 2 pages
GSA3688
Employee's Service Agreement for Receipt of a Recruitment Incentive
39 fields, 2 pages
GSA3689
Employee's Service Agreement for Receipt of a Relocation Incentive
40 fields, 2 pages
GSA3690
Employee's Service Agreement for Receipt of a Retention Incentive
36 fields, 2 pages
Who uses GSA Form 3691?
The form names these parties.
Official sources and the blank
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Questions about Form GSA3691
Who issues GSA Form 3691?
The footer reads GENERAL SERVICES ADMINISTRATION, GSA 3691 3/2026. GSA hosts it in its forms library, and GSA's page lists the authority as 5 U.S.C. § 5379.
Which loans does the form list?
Item 9 lists FFEL loans, William D. Ford Direct Loan Program loans, Federal Perkins Loan Program loans and loans made or insured under the Public Health Service Act. It notes the loan must be Federally-insured, and the instructions say private loans are not eligible for repayment.
Where does the lender's TIN in item 6 come from?
The instructions ask for the Employer ID number of the loan servicing institution and say it is usually available on the Internet or by calling its Customer Service telephone number.
Does GSA mail a check to the lender?
The form says it is used to process an electronic funds payment. The instructions say the servicer's mailing address will not be used to mail a check and is needed only for any follow-up written correspondence.
What does the form say to attach?
A copy of the printout from the Internet showing the loan balances and the date they were verified online with the lender, stapled to the form.
Who sees the information on GSA Form 3691?
The Privacy Act Statement says it will only be used by the GSA Office of Chief Financial Officer, is not releasable to the public under 5 U.S.C. § 552(b)(6), and is stored in OPM's Electronic Personnel Folder (eOPF).