Information Collection

Contractor Information Worksheet, GSA Form 850

IC 188501 under ICR 201704-3090-003 · OMB 3090-0283.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3090-0283 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form GSA 850 Contractor Information Worksheet, GSA Form 850	Form and Instruction
GSA 850 Contractor Information Worksheet GSA 850 2017.pdf	Form and Instruction

IC Title:

Contractor Information Worksheet, GSA Form 850

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	GSA 850	Contractor Information Worksheet	GSA 850 2017.pdf		Yes	No	Fillable Fileable

Line of Business: Supply Chain Management

Subfunction: Services Acquisition

Privacy Act System of Records

Title: Privacy Act of 1974; Notice of Updated Systems of Records

FR Citation: 73 FR 35690

Number of Respondents: 25,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	25,000	25,000
Annual IC Time Burden (Hours)	6,250	6,250
Annual IC Cost Burden (Dollars)	248,625	248,625

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.