Information Collection

Living Quarters Eligibility Questionnaire; GSA Form 5039

IC 262266 under ICR 202309-3090-001 · OMB 3090-0331.

Documents and Forms

Document Name Document Type
Form GSA 5039 Living Quarters Eligibility Questionnaire; GSA Form 5039 Form and Instruction
GSA 5039 LIVING QUARTERS ELIGIBILITY QUESTIONAIRE GSA Form 5039-final_3_20_2023 (1).pdf Form and Instruction
GSA 5039 LIVING QUARTERS ELIGIBILITY QUESTIONAIRE GSA Form 5039-final_3_20_2023 (1).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Living Quarters Eligibility Questionnaire; GSA Form 5039	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	GSA 5039	LIVING QUARTERS ELIGIBILITY QUESTIONAIRE	GSA Form 5039-final_3_20_2023 (1).pdf		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records
Title: OPM/GOVT-1 General Personnel Records	FR Citation: 80 FR 74815

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.