GSA850
Contractor Information Worksheet
GSA Form 850, Contractor Information Worksheet, is a General Services Administration form, GSA 850 (REV. 2/2025), marked For Official Use Only, with OMB Control Number 3090-0283 and an expiration date of 9/30/2028. GSA's page lists CIO 2182.2 as its authority or regulation, and the instructions say to use the worksheet for all GSA contractors.
Section 1 is completed by the contractor: the contract employee's name, sex, Social Security number, date and place of birth, home address, work phones, personal email, job title, prior investigation, U.S. citizenship, and entry details for non-U.S. citizens. Sections 2 to 6 are completed by the GSA requesting official: contract information and company points of contact, any reimbursable work authorization or interagency agreement, the project or work location, the type of investigation requested, and the requesting official's own details.
The Privacy Act notice says the form will be used as a means to prepare and issue a credential or pass. GSA estimates 15 minutes to read the instructions, gather the facts and answer the questions.
Full name (or NMN if no middle name), suffix, sex, SSN, date and place of birth, home address, work phones, personal email, job title, prior investigation, U.S. citizen, and port of entry, date of entry, alien registration number and country of citizenship for non-U.S. citizens.
Prime and subcontractor company names, Unique Entity Identifier (UEI), task or delivery order number, contract number and type, start and end dates, option years and company points of contact.
RWA/IAA number and agency if applicable, then the GSA building number or other site, contractor type, ARRA long term contractor, sponsoring organization and office symbol, and GSA region.
The investigation type request and whether a Homeland Security Presidential Directive (HSPD 12) card is required.
Name, email address and work phone of the GSA requesting official and up to four alternates.
Contractor type definitions, GSA region options, rules for transmitting the worksheet, submission information and the Privacy Act notice.
Enter the contract employee's identifying, address, contact, job title, prior investigation and citizenship details.
Non-U.S. citizens also give the U.S. port of entry city and state, date of entry, whether less than 3 years U.S. resident, alien registration number and country of citizenship.
Enter the contract, any RWA or IAA, and the work location, choosing a contractor type from the definitions on the back.
In Section 5, enter the investigation type requested and whether an HSPD 12 card is required.
In Section 6, enter the requesting official and any alternates with email and work phone.
The form says to check with your GSA regional point of contact for instructions on how to submit the completed form.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
The form says to check with your GSA regional point of contact for instructions on how to submit the completed form.
The form says not to save completed forms on your workstation, to encrypt PII sent over the Internet under GSA Order CIO 2100.1L CHGE 1, to use Google Mail within the GSA network, and to use a secure fax line or courier marked signature required.
OMB Control Number 3090-0283, expiration date 9/30/2028. GSA estimates 15 minutes per response. Comments on the estimate go to U.S. General Services Administration, Regulatory Secretariat Division (MVCB), 1800 F Street, NW, Washington, DC 20405.
Solicitation is authorized by the Federal Property and Administrative Services Act of 1949, as amended, and Part III of Title 5, U.S.C; E.O. 9397. The notice says disclosure of the information is voluntary.
The notice says the employee will not be issued a credential and will not be allowed to enter a GSA-controlled building after normal hours or when the building is under security.
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Each section header says who completes it. The instructions say to use the worksheet for all GSA contractors.
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The footer reads GENERAL SERVICES ADMINISTRATION and GSA 850 (REV. 2/2025), with OMB Control Number 3090-0283. GSA's page lists CIO 2182.2 as its authority or regulation.
Section 1 is marked To Be Completed By Contractor. Sections 2 to 6 are marked To be completed by GSA Requesting Official.
The Privacy Act notice says the form will be used as a means to prepare and issue a credential or pass.
Building Support (building maintenance or construction support), Embedded (side-by-side or white collar business services with possible staff-like access), External (no access to GSA buildings or IT systems but needs a check or investigation) and Child Care.
The form says to check with your GSA regional point of contact for instructions on how to submit it, and gives rules for sending PII securely.
The notice says disclosure is voluntary, and that without the information the employee will not be issued a credential and will not be allowed to enter a GSA-controlled building after normal hours or when the building is under security.
GSA estimates 15 minutes to read the instructions, gather the facts and answer the questions.