Opening request statement
The requestor, the reemployed annuitant, the requesting organization, the unusual circumstance for which the individual's services are needed, the appointing authority, and the position title, series and grade.
GSA3694
Request for Waiver of Dual Compensation (Salary Offset) Other Unusual Circumstances
- Agency
- GSA
- Revision
- Rev. 4/2009
- Fillable fields
- 19
- Pages
- 2
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 3694: Waiver of Dual Compensation (Salary Offset) Other Unusual Circumstances
GSA Form 3694, Request for Waiver of Dual Compensation (Salary Offset) Other Unusual Circumstances, is a two-page General Services Administration form, Rev. 4/2009. A requesting organization uses it to ask for a dual compensation reduction (salary offset) waiver to reemploy an annuitant for work needed as a result of an unusual circumstance, under the criteria in 5 CFR 553.201 (f), "Requests based on other unusual circumstances."
The form opens with a fill-in statement naming the requestor, the reemployed annuitant, the requesting organization, the unusual circumstance, the appointing authority and the position by title, series and grade. Four numbered parts follow: the unusual circumstance, its relationship to the agency's mission, why it could not be avoided, and the need for the individual's services. The form prints no signature block, no approving official and no filing address.
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What's on GSA Form 3694
(1) The unusual circumstance
What the unusual circumstance is, when it first occurred, and how long it is expected to last.
(2) Relationship to the agency's mission
How the waiver request directly supports the agency's mission.
(3) Why it could not be avoided
How or why the unusual circumstance could not have been avoided, anticipated or addressed prior to the waiver request.
(4) Need for the individual's services
The knowledge, skills and abilities that make the annuitant uniquely qualified, or a showing that the number of positions to be filled or the time sensitivity of the work justifies the appointment without further delay.
How to complete GSA Form 3694
- 1
Fill in the opening statement
Enter the requestor's name, the reemployed annuitant and the requesting organization, then describe the unusual circumstance for which the individual's services are needed.
- 2
Name the appointment
Enter the appointing authority that will be used to reemploy the annuitant, and the position title, series and grade.
- 3
Describe the circumstance and the mission
Complete parts 1 and 2: the unusual circumstance, when it first occurred and how long it is expected to last, and how the request directly supports the agency's mission.
- 4
Explain why it could not be avoided
In part 3, describe how or why the circumstance could not have been avoided, anticipated or addressed before the waiver request.
- 5
Show the need for the individual
In part 4, describe the annuitant's knowledge, skills and abilities, or the number of positions or time sensitivity that justifies the appointment without further delay.
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Where it goes and what the form says
Where it goes
The PDF prints no filing address, signature block or approving official. GSA's page lists no authority or regulation for this form.
Regulation named on the form
5 CFR 553.201 (f), "Requests based on other unusual circumstances." The form says the criteria for approving a waiver are met and supported by the information in its four numbered parts.
Companion form
GSA Form 3693 is the request for the same waiver under 5 CFR 553.201 (e), "Requests based on the need to retain an individual."
Related forms
Who prepares GSA Form 3694?
The form is written as a request from an official and an organization on behalf of a reemployed annuitant.
Official sources and the blank
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Questions about Form GSA3694
Who fills out GSA Form 3694?
The form is written as a request from a named requestor and a requesting organization for a dual compensation reduction (salary offset) waiver for a reemployed annuitant.
What regulation does the form cite?
5 CFR 553.201 (f), "Requests based on other unusual circumstances."
What does the form ask about the unusual circumstance?
Part 1 asks what it is, when it first occurred and how long it is expected to last. Part 3 asks how or why it could not have been avoided, anticipated or addressed prior to the waiver request.
Does part 4 have to be about the annuitant's qualifications?
Part 4 asks for the knowledge, skills and abilities that make the annuitant uniquely qualified, or to demonstrate that the number of positions to be filled or the time sensitivity of the work justifies making the appointment without further delay.
How is it different from GSA Form 3693?
GSA Form 3694 cites 5 CFR 553.201 (f), other unusual circumstances. GSA Form 3693 cites 5 CFR 553.201 (e), the need to retain an individual for a specific project.
Where is GSA Form 3694 sent?
The PDF prints no filing address, signature block or approving official.