GSA 5040 Overseas Employment Service Agreement

OVERSEAS EMPLOYMENT SERVICE AGREEMENT

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OMB Control Number: XXXX-XXXX
Expiration Date: XX/XX/20XX

(See Privacy Act Statement and Paperwork Reduction Act Statement on Page 2)
1. Name (Last Name, First Name, Middle Initial)

2. Social Security Number

3. Actual Place of Residence in the U.S. (Street Address, City or Territory, State and
Postal Code)

3a. If no U.S. actual place
of residence during this
tour, check this box.
5. Duty Station Code (9 digits)

4. Location of Overseas Post (City, Country Name)
6. Type of Overseas Post and Post Name (Check One)
DoD Joint Base

Army Installation

Navy Installation

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Other
6a. Name of Overseas Post

Air Force Installation

U.S. Embassy

U.S. Consulate

7. Sponsoring Agency or Department Serviced by the Memorandum of Agreement (MOA) and this Agreement (Check One)
Army (DoD)

Navy (DoD)

Air Force (DoD)

U.S. State Department

U.S. Foreign Commercial Service

Other
7a. Projected Date of Arrival at Overseas Post (MM/DD/YYYY)

7b. Tour of Duty End Date (MM/DD/YYYY)

8. Appointee's Organization (Service or Staff Office) (Check box or complete as appropriate)
GSA Federal Acquisition Service (FAS)
GSA Staff Office (name):

GSA Public Buildings Service (PBS)

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8b. U.S. Post for Assignment Upon Expiration of the Final Overseas Tour (City, State or Territory)

8a. Organization Code
(8 digits)
8c. Duty Station Code
(9 digits)

9. LENGTH OF ASSIGNMENT
You will be assigned to the foreign post listed above for a period of:

months.

Upon renewal of this tour of duty, or upon reassignment to a different overseas post, a new agreement should be completed and
signed.
10. TRAVEL AND TRANSPORTATION EXPENSES TO AND FROM THE OVERSEAS POST
The cost involved in your travel and transportation (including that of immediate family and household goods, if authorized) to your
overseas post will be paid by the GSA with the understanding that you will remain in service outside the United States for a period
of one year (i.e., 12 months or 26 pay periods) following the date of your arrival overseas.
Return transportation expenses will be paid by the GSA, provided that you complete the tour of duty prescribed above. These
expenses will be paid according to your "place of actual residence":
(i.e., U.S. City, State or Territory).*

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*Travel and transportation expenses will be paid according to the "actual place of residence." The GSA Office of Human Resources Management (OHRM) is
responsible for determining the "actual place of residence" prior to the employee's actual departure for an overseas assignment.

11. HOME LEAVE AND 45-DAY LEAVE ACCRUAL
Appointees who meet the requirements of the United States Code at 5 U.S.C. § 6304(b) for the maximum accumulation of 45 days
of annual leave per year are also eligible for "home leave" under 5 U.S.C § 6305(a).
To be eligible for home leave, the job candidate must have either: (a) been transferred from the U.S. to the foreign area, or (b)
been hired within the foreign country but: (1) was originally recruited from the United States or its territories or possessions, (2)
has been in substantially continuous employment by other agencies of the United States, United States firms, interests, or
organizations, international organizations in which the United States participates, or foreign governments, and (3) had prior
conditions of employment that provided for return transportation to the United States (or its territories or possessions). Check One
This job candidate is eligible for 45-day annual leave accrual and home leave
This job candidate is not eligible for 45-day annual leave accrual and home leave
GENERAL SERVICES ADMINISTRATION

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12. DIFFERENTIALS AND ALLOWANCES
This position has been approved for the following (check all that apply):
Post Allowance

Post Hardship Differential

Danger Pay

Educational Allowance

Living Quarters Allowance

Other Allowance (describe):
Note: The allowances approved for this position are subject to the terms of the MOA between GSA and the serviced agency
(such as DoD), GSA allowance policy and the Department of State Standardized Regulations (DSSR).
13. EFFECT OF FAILURE TO FULFILL TERMS OF AGREEMENT
In the event you fail to fulfill the terms of this agreement, or any subsequent agreement, any money expended by the GSA on
account of permanent change of station travel and transportation shall be recovered from you as a debt due to the United States,
under the conditions specified in 5 U.S.C. Chapter 57 and the Code of Federal Regulations at 41 C.F.R. Part 302. You will only
be required to make such restitution as is required by law and regulation (e.g., 31 U.S.C. Chapter 37 and 5 U.S.C. § 5514).

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14. CERTIFICATON
Under 5 U.S.C. § 5722, 5724, and 5724a, and the Federal Travel Regulations at 41 C.F.R. § 302-2.14, I agree to remain in the
service of GSA for a period of at least 1 year following GSA’s payment, or reimbursement, of permanent change of station
relocation expenses. I understand that if I do not complete this service period that I will be considered indebted for those
relocation expenses.
I also understand that if I separate from GSA (due to agency transfer, resignation, etc.) before completion of the tour of duty
specified in this agreement that GSA is under no obligation to pay for the transportation of myself, my family, and household
goods and personal effects from my overseas post of duty back to my place of actual residence within the United States.

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I hereby certify that I have read and understood the foregoing statements and agree to the terms discussed above.

(Signature of Job Candidate)

(Date)

(Signature of Selecting Official)

(Date)
PRIVACY ACT STATEMENT

Collection of the information in this Direct Deposit Sign-Up Form is authorized by 5 U.S.C. § 552a, 31 U.S.C. § 3332(g), and
Executive Order 9397 (November 22, 1943). Your social security number and the other information requested will allow the
Federal Government to process your direct deposit. Your social security number is requested to ensure the accurate identification
and retention of records pertaining to you and to distinguish you from other recipients of federal payments. This information will
be disclosed to the Department of the Treasury and its fiscal and financial agents, and other federal agencies, as necessary to
process your direct deposit. This information may also be disclosed to a court, congressional committee or another government
agency as authorized or required to verify your receipt of federal payments. Although providing the requested information is
voluntary, your direct deposit cannot be processed without it.

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PAPERWORK REDUCTION ACT STATEMENT
This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction
Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB)
control number. The OMB control number for this collection is XXXX-XXXX. We estimate that it will take XX hours to read the
instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including
suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services
Administration, Regulatory Secretariat Division (MVCB), 1800 F Street, NW, Washington, DC 20405.

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INSTRUCTIONS
This form should be completed by the human resources specialist filing the position. The selected job candidate may need to
provide the human resources specialist with more information, or additional documents than were in the original staffing file, used
in the selection process. This employment agreement is meant to transcribe, in one convenient place, the information necessary
to determine the foreign allowances applicable to the position as well as information used for budget estimation and the
administration of permanent change of station relocation expenses.
1. Name: Please provide your full name.
2. Social Security Number: Please provide your full Social Security number.
3. Actual Place of Residence in the U.S.: The actual place of permanent residence in the U.S. determination is a requirement
of certain laws, such as 5 U.S.C. 5722 (PCS for a new appointee from the U.S. to the overseas post, and back again). The
human resources specialist should determine the actual place of residence based on the Comptroller General Opinion, Rafael
Arroyo, B-197205, May 16, 1980: (1) physical residence, (2) residence provided in agency records, (3) residence according to
employment history, (4) individual or family association with an area, and (5) exercise of privileges and duties, such as voting,
and income tax and property tax. Other Comptroller General opinions have added other consideration factors, such as the
place of birth, education, or marriage.

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4. Location of Overseas Post: The human resources specialist should fill in the country and city of the overseas post, since this
information is critical when determining the amounts of foreign allowances that may be applicable under the DSSR.
5. Duty Station Code: Every Federal duty station has a 9-digit duty station code, whether domestic, non-foreign or foreign. Use
this website to determine the duty station code: https://dw.opm.gov/datastandards/dutystation/searchbyname
6. Type of Overseas Post and Post Name: This block concerns the type of foreign post and the name of the foreign post. This
information helps to determine what resources are available for the job candidate, in particular, base housing and base medical
services, for the job candidate.

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7. Sponsoring Agency or Department Serviced by the MOA and this Agreement: This data element captures the partner
agency within the U.S. Government that is sponsoring the work done by GSA and GSA's position at the foreign post.
7a and 7b. Projected Date of Arrival and Tour of Duty End Date: This information helps the agency to plan the permanent
change of station of the job candidate, as well as other considerations, such as temporary quarters subsistence
allowance. The end date of the tour is also used to determine when a managerial decision is made whether or not to
allow the job candidate to remain at that foreign post, or, if the job candidate will instead be offered a job opportunity
back in the United States.
8. Appointee's Organization: For this row, please annotate which line or staff office that is employing the job candidate and
also list the Organization Code, which is up to 4 digits, alpha-numeric.
8b. U.S. Post for Assignment Upon Expiration of the Final Overseas Tour: Employees stationed overseas generally are not
considered permanent employees in a foreign country due to the nature of the Status of Forces agreement between the U.S.
and the foreign country. When the employee's future location has not been fully identified, users of the form may mark
"TBD" (for To Be Determined) or "Nationwide" or "[GSA Organization] Nationwide" such as "FAS Nationwide."

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9. Length of Assignment: The length of assignment should match the time specified within the MOA between the agency and
GSA. Typically the initial assignment is 3 years, and renewals are 2 years (up to 3 years). The length of the assignment
confirms that the sponsoring agency is able to pay for the function back to the U.S. This data element also helps to determine,
in certain cases, a timeline for eligibility for home leave under 5 U.S.C. § 6305. When the employee's future location has not
been fully identified, users of the form may mark "TBD" (for To Be Determined) or "Nationwide" or "[GSA Organization]
Nationwide" such as "FAS Nationwide."
10. Travel and Transportation Expenses to and From the Overseas Post: This data element asks the human resources
specialist to identify the "actual place of residence" for the purposes of determining costs for the foreign permanent change of
station and also notifies the job candidate that there is a 12-month service agreement required by law and regulation once an
agency has paid for these relocation expenses.

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11. Home Leave and 45-day Leave Accrual: This section describes whether or not a job candidate is eligible for home leave
and the 45‐day leave accrual ceiling. Not all hires are eligible for these authorities.
12. Differentials and Allowances: This section describes the various differentials and allowances that the candidate is eligible
for and have been authorized for the position.
13. Effect of Failure to Fulfill Terms of Agreement: This section notifies the job candidate that if he or she does not satisfy the
12-month service requirement following permanent change of station GSA may create a receivable and collect the debt
through salary administrative offset.
14. Certification: This section asks the job candidate to ready carefully the full form, as completed by the human resources
specialist, and that the job candidate agrees with the information and understands the requirements for accepting the GSA
position and the offer of assignment to the foreign post. The agency signature should generally be the human resource
specialist at GSA filling the position.

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