Contractor Information Worksheet; GSA Form 850

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form GSA 850 Contractor Information Worksheet	Form and Instruction	Modified	Available
GSA IC Non sub request_3090-0283.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2026-09-22	Available
3090-0283-Supporting Statement (4).docx	Supporting Statement A	Uploaded 2025-07-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
188501	Contractor Information Worksheet, GSA Form 850	Form and Instruction	Modified	Contractor Information Worksheet

ICR Details

OMB Control No: 3090-0283	ICR Reference No: 202609-3090-003
Status: Received in OIRA	Previous ICR Reference No: 202507-3090-002
Agency/Subagency: GSA	Agency Tracking No:
Title: Contractor Information Worksheet; GSA Form 850
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/22/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	09/30/2028	09/30/2028
Responses	22,824	22,824
Time Burden (Hours)	5,706	5,706
Cost Burden (Dollars)	358,109	358,109

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Abstract: Information collected through the Contractor Information Worksheet is necessary to meet: ● The Office of Management and Budget (OMB) Guidance M-05-24 for Homeland Security Presidential Directive (HSPD) 12 which authorizes Federal departments and agencies to ensure that contractors/their employees have limited/controlled access to facilities and information systems, and ● GSA Directive CIO P 2181.1 Homeland Security Presidential Directive-12 Personal Identity Verification and Credentialing which states that GSA contractors/their employees must undergo a minimum of a FBI National Criminal Information Check (NCIC) to receive unescorted physical access. GSA requires the collection of the information in the Contractor Information Worksheet to authorize and initiate background check requests for GSA contractor employees and for them to obtain a GSA access card. The background checks are carried out by the Office of Personnel Management, Facilities, Security & Contracting-Personnel Security (OPM FSC) and the credentialing process is carried out by the GSA’s Managed Service Office (MSO) in accordance with the terms and conditions of separate Memoranda of Agreement (MOAs). 2. Use of the Information. The GSA requesting official, referred to as “Sponsor,” collects and inputs the Contractor Information Worksheet data into the GSA Credential and Identity Management System (GCIMS). GSA Office of Mission Assurance (OMA) Identity, Credential and Access Management (ICAM) Division then uploads the relevant contractor data from GCIMS to the OPM e-QIP system for initiation of the contractor background investigation process. GCIMS automatically sends relevant data to the MSO for enrollment, including digital fingerprints for investigation and GSA access card, if needed. The OPM FSC performs the required background checks for GSA contractor employees once the applicant completes the e-QIP and fingerprinting process. The requesting official is responsible for requesting the investigation and/or GSA access card. Often the GSA requesting official is the Contracting Officer’s Representative (COR) for the contract, but this role may be fulfilled by a project manager, Public Buildings Service (PBS) building manager, or local Access Card Point of Contact (POC) as appropriate. If the applicant has a prior background check, OPM FSC uses the information in e-QIP to verify the prior determination. When OPM FSC makes an access determination, they notify the OMA ICAM Division. The OMA ICAM Division will input the results into GCIMS and notify the applicant, GSA sponsor, GSA POCs, and contractor’s point of contact.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 21929	05/22/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 35302	07/25/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Contractor Information Worksheet, GSA Form 850	GSA 850	Contractor Information Worksheet

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	22,824	22,824	0	0	0	0
Annual Time Burden (Hours)	5,706	5,706	0	0	0	0
Annual Cost Burden (Dollars)	358,109	358,109	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $199,722

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/22/2026

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