Item 1: the assignment
Position title, series, grade and location. The form says the agreement between GSA and the undersigned becomes effective upon assignment to that position.
GSA5041
Overseas Employment Agreement Assignment to a Foreign Area (Without Return Rights)
- Agency
- GSA
- Revision
- Rev. 7/2018
- Fillable fields
- 9
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 5041: Overseas Employment Agreement, Foreign Area (Without Return Rights)
GSA Form 5041, Overseas Employment Agreement Assignment to a Foreign Area (Without Return Rights), is a one-page General Services Administration (GSA) form printed as GSA 5041 7/2018. GSA hosts it in its forms library, and GSA's page lists HRM 9301.1 as its authority or regulation. The form prints no OMB number.
The form says it is signed by an employee or applicant on a career or career conditional appointment without return rights who was selected for assignment to a GSA position in a foreign area and is eligible to sign a transportation agreement. It excludes family members of military members or civilian employees on a permanent change of station (PCS) move to the foreign area.
The agreement limits how long the employee may remain in an overseas area and states that the employee does not have return rights. The employee and the supervisor sign and date it. You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 5041
Item 2a: initial tour
The initial period of overseas service is limited to the established tour of duty for the area, which is used to establish return transportation entitlement.
Item 2b: renewal agreement travel
If the employee is authorized and elects renewal agreement travel for another tour, service is limited to the tour required by that agreement.
Item 3: no return rights
The employee does not have return rights, will be provided placement assistance, and may be subject to involuntary separation.
Item 4 and signatures
The employee accepts the conditions, then the employee and the supervisor each sign and date, with the location below.
How to complete GSA Form 5041
- 1
Fill in the assignment
Enter the position title, series, grade and location in item 1.
- 2
Read the time limits in item 2
The form says any extension beyond the tour of duty is subject to the employee's concurrence and management approval.
- 3
Read item 3 on return rights
It states that the employee does not have return rights and may be subject to involuntary separation.
- 4
Sign and date
The employee signs and dates, then the supervisor signs and dates, and the location is entered.
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What the form says
Where it goes
The form gives no submission address. It says the agreement is between GSA and the undersigned and takes effect upon assignment to the position in item 1.
Extensions
Any extension beyond the established tour, or beyond a renewal tour, is subject to the employee's concurrence and management approval.
Not printed on the form
The form prints no OMB control number, Privacy Act statement or time estimate.
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Who signs GSA Form 5041?
The opening paragraph of the form says who signs it and who is excluded.
Official sources and the blank
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Questions about Form GSA5041
Who issues GSA Form 5041?
It is a General Services Administration form, printed as GSA 5041 7/2018. GSA hosts it in its forms library, and GSA's page lists HRM 9301.1 as its authority or regulation.
Who signs GSA Form 5041?
The form says an employee or applicant on a career or career conditional appointment without return rights, selected for a GSA position in a foreign area and eligible to sign a transportation agreement, signs it. The supervisor also signs.
What does without return rights mean on this form?
Item 3 says the employee does not have return rights, will be provided placement assistance, and that employees without return rights may be subject to involuntary separation.
How long does the overseas tour last?
Item 2 says the initial period is limited to the established tour of duty for the area, and a renewal tour to the tour required by that agreement. Extensions are subject to the employee's concurrence and management approval.
Who is excluded from GSA Form 5041?
The form excludes family members of military members or civilian employees who are on a permanent change of station (PCS) move to the foreign area.