Items 1 to 5: the request
Requesting agency file number, date of request, proposed shipping date, the GSA office it goes to, and the date the shipment is needed at destination.
GSA420
Freight Rate and Route Request/Response
- Agency
- GSA
- Revision
- Rev. 9/1977
- Fillable fields
- 119
- Pages
- 2
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 420: Freight Rate and Route Request/Response
GSA Form 420, Freight Rate and Route Request/Response, is a General Services Administration form, Rev. 9/1977. GSA's page lists FPMR 101-40.301 as its authority or regulation and hosts the form in its forms library.
The form has two halves. The requesting agency describes a shipment on the top half: rate types wanted, size and weight, commodity, shipper, receiver, origin, destination and rail routing. The bottom half is the rate/route response, for completion by GSA, with the authorized routes, rates, minimum weight, tariff authority and a GSA control number. Item 28 on the back covers shipments with several origins, destinations or commodities.
The form says the requesting agency should complete items 1 through 19 and 28, if applicable, and submit the original and two copies to the GSA office responsible for issuing rate/routing instructions. You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 420
Items 6 to 10: agency, rate types and size
The requesting agency and contact, the types of rates requested (truck, rail, air, import, export, domestic, rate and route via cheapest mode, or other), carloads or truckloads, shipment size and gross weight in lbs.
Items 11 to 15: commodity and addresses
The commodity description, the consignor (shipper) and consignee (receiver) with mailing addresses, and the freight addresses of the actual shipping point and receiving point.
Items 16 to 19: GBL, rail and special needs
Whether a GBL is requested, rail routing details with the rail carrier serving each end and any private siding, additional shipping information, and the GSA control number of a previous similar request, if any.
Items 20 to 27: GSA's response
Routes authorized, rates in cents per 100 lbs., minimum weight in lbs., tariff or other rate authority, a bill of lading description when different from item 11, remarks, technician, issuing officer, GSA control number and date issued.
Item 28 on the back: several shipments
A table the requesting agency fills for each commodity, origin and destination, and GSA answers with rate, minimum weight, tariff or other rate authority and route authorized, plus remarks columns for each side.
How to complete GSA Form 420
- 1
Fill in items 1 through 19
The form says the requesting agency should complete items 1 through 19. Item 4 takes the complete mailing address of the GSA office that issues rate/routing instructions.
- 2
Describe the commodity
Item 11 asks for a UFC or NMFC number or a clear nontechnical description, and the number of packages as prepared for shipment, such as crated, uncrated, boxes, skids, loose, SU or KD.
- 3
Note unusual size or handling
Item 18 is for articles of unusual size or weight, special handling such as hazardous materials, and special carrier service such as exclusive use of a vehicle.
- 4
Use item 28 for more than one shipment
The note beside item 11 says to complete item 28 on the back if there are multiple origins, destinations or commodities.
- 5
Leave the response section blank
The form says not to write below the line marked rate/route response, which is for completion by GSA.
- 6
Send the original and two copies
Submit the original and two copies to the GSA office responsible for issuing rate/routing instructions, as the form says.
Why fill Form GSA420 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the GSA, not a copy someone retyped
- Works on a phone, tablet or computer
Where it goes and what the form says
Where it goes
The original and two copies go to the GSA office responsible for issuing rate/routing instructions, whose complete mailing address the agency enters in item 4.
How long a response applies
The form says traffic data furnished is as of the date in item 27. If the shipment is not made in a reasonable period, a new request should be submitted referencing the control number in item 26.
Authority
GSA's page lists FPMR 101-40.301 as the authority or regulation and 09/1977 as the current revision date.
What the PDF does not print
The PDF prints no fee, OMB number, burden estimate or privacy statement.
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Who uses GSA Form 420?
The form is passed between a requesting agency and GSA. These are the parties and roles it prints.
Official sources and the blank
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Questions about Form GSA420
Who issues GSA Form 420?
It is a General Services Administration form, printed GSA FORM 420 (REV. 9-77). GSA's page lists FPMR 101-40.301 as its authority or regulation.
Which items does the requesting agency fill in?
The form says the requesting agency should complete items 1 through 19, and item 28 on the back if applicable. Items 20 to 27 are for completion by GSA.
What if a shipment has several origins or commodities?
The form says to complete item 28 on the back if there are multiple origins, destinations or commodities.
How long is GSA's rate/route response good for?
The form says the traffic data is as of the date shown in item 27. If the shipment is not made in a reasonable period, a new request should be submitted with reference to the control number in item 26.
How are rates shown on the response?
Item 21 shows the rate in cents per 100 lbs., the minimum weight in lbs. and the tariff or other rate authority. Item 20 lists the routes authorized.
Can I refer to an earlier request?
Item 19 asks for the GSA control number assigned to a previous request for similar rate/routing instructions, if any.