Ticket or GTR and charge card
Date, file reference, government charge card number, ticket number or Government Transportation Request (GTR) number, and the date and place the ticket or GTR was issued.
SF1170
Redemption of Unused Tickets - Original
- Agency
- GSA
- Revision
- Rev. 4/2001
- Fillable fields
- 50
- Pages
- 1
- Official source
- GSA form page
- Checked
- October 20, 2026
Standard Form 1170 (SF 1170): Redemption of Unused Tickets - Original
Standard Form 1170 (SF 1170), Redemption of Unused Tickets - Original, is a one-page request for a refund of unused passenger transportation. The footer says it is prescribed by GSA, FMR (41 CFR) 102-118, in the Rev. 4/2001 edition, and GSA hosts it in its forms library.
The form says refund is requested for each segment of unfurnished passenger transportation services listed, and that any unused tickets involved are attached. It records the ticket number or Government Transportation Request (GTR) number, the government charge card number, the passenger, the origin and destination, each unused segment, and the name and address to which the refund is to be made. A column marked FOR CARRIER'S USE ONLY holds the amount of refund.
The instructions are addressed to Transportation Service Providers (TSPs), and a notice at the bottom says the debt is now due. You can fill it out free in your browser on this page and download the result without an account.
What's on SF 1170
Passenger and route
Passenger's name, origin and destination.
Unused segments
Rows for form no., ticket no., number of passengers and fare basis, unused from and unused to.
Amount of refund
A column marked FOR CARRIER'S USE ONLY for the amount of refund on each row, and a total.
Remarks and addresses
Remarks, the transportation service provider's name and address, the agency's appropriation, and the name and address to which the refund is to be made.
Instructions and notice
Four instructions for TSPs, then a notice about the debt, interest, administrative costs, penalty charges and administrative setoff.
How to complete SF 1170
- 1
Fill in the ticket details
Enter the date, file reference, government charge card number, ticket or GTR number, date and place issued, passenger's name, origin and destination.
- 2
List each unused segment
Enter the form no., ticket no., number of passengers and fare basis, and the unused from and to points. The form says any unused tickets involved are attached.
- 3
Add the provider and refund address
Enter any remarks, the transportation service provider's name and address, the agency's appropriation, and the name and address to which the refund is to be made.
- 4
The TSP enters the refund amounts
The instructions say the TSP inserts the value of each unused ticket in the Amount of Refund column and does not credit the value of unused tickets on other bills.
- 5
Return the original with the check
The instructions say the original copy should be returned to the agency specified on the form with the check covering the refund due.
Why fill Form SF1170 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 copy goes back to the agency specified on the form with the check covering the refund due. The form says the check may be made payable to the agency or the Treasury of the United States.
Payment terms in the notice
The notice says the debt is now due, interest accrues from the date of the notice, and interest, administrative costs and penalty charges apply if it is not paid within 30 days of the date of this notice.
Setoff and review
The notice says the agency to which refund is to be made may collect the claim by administrative setoff, and that agency records may be inspected and copied, an agency review obtained and a written repayment agreement proposed.
Billing rules for TSPs
The instructions say TSPs should not credit the value of unused tickets on other bills, and should not ask the agency for payment or billing identification of the bill that covered the charge card or GTR charges.
Reproduction and edition
The footer says AUTHORIZED FOR LOCAL REPRODUCTION, PREVIOUS EDITION IS NOT USABLE and STANDARD FORM 1170 (REV. 4/2001).
Related forms
Who uses SF 1170?
The instructions name two parties: the agency to which the refund is to be made and the Transportation Service Provider (TSP).
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Questions about Form SF1170
Who issues SF 1170?
The footer says it is prescribed by GSA, FMR (41 CFR) 102-118. GSA's page lists the same regulation as its authority.
Who enters the refund amount?
The instructions say the value of each unused ticket is inserted by the TSP on the face of the original copy, in the Amount of Refund column, which is marked FOR CARRIER'S USE ONLY.
Where does the original copy of SF 1170 go?
The instructions say the original copy should be returned to the agency specified on the form with the check covering the refund due, payable to the agency or the Treasury of the United States.
Can a TSP credit the unused tickets on another bill?
The instructions say TSPs should not effect adjustment by crediting the value of unused tickets in presenting charges on other bills.
What does the notice say about late payment?
It says interest accrues from the date of the notice, and that interest, administrative costs and penalty charges apply if the debt is not paid within 30 days of the date of this notice.
Are the unused tickets sent with the form?
The form says any unused tickets involved are attached.