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OMB Control No: 3090-0333	ICR Reference No: 202405-3090-001
Status: Active	Previous ICR Reference No:
Agency/Subagency: GSA	Agency Tracking No:
Title: Actual Place of Residence Determination; GSA Form 5047
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/14/2024
	Date Received in OIRA: 05/01/2024
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2027	36 Months From Approved
Responses	25	0	0
Time Burden (Hours)	25	0	0
Cost Burden (Dollars)	0	0	0

Abstract: This form will be used to support the placement of individuals into positions in foreign areas, outside of the U.S., its territories or possessions. The information needed to complete the form is collected by human resources specialists within the Office of Human Resources Management (OHRM) who are processing civil service appointments of job candidates new to the agency or reassignments of existing GSA employees to positions abroad. The information collected is used to determine a job candidate’s “actual place of residence” in the U.S. which is an aspect of allowance and benefits determination for various Title 5 personnel and travel authorities (i.e., permanent change of station, renewal agreement travel, home leave and the 45-day leave accrual ceiling). All of these authorities are only available to permanent residents of the U.S. and are not available to “local hires” who are American expatriates who have severed ties with the U.S. and are permanent residents of the foreign country. This form is particularly helpful in the complicated situations of job candidates by agency transfer who are already living and working in the foreign country. In these situations, the continuing jurisdictional nexuses to the U.S. must be better understood and documented and additional supporting documentation is also necessary (i.e., job history and a transportation agreement from the losing agency promising return transportation to designated U.S. place of residence).

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 13341	02/22/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 35097	05/01/2024
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Actual Place of Residence Determination; GSA Form 5047	GSA 5047

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	25	25
Annual Time Burden (Hours)	25	25
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new information collection.

Annual Cost to Federal Government: $1,800

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

Agency Contact: Colin Bennett 717 359-7735

View ICR - OIRA Conclusion