View Information Collection Request (ICR) Package

OMB Control No: 3090-0283	ICR Reference No: 202507-3090-002
Status: Active	Previous ICR Reference No: 202207-3090-006
Agency/Subagency: GSA	Agency Tracking No:
Title: Contractor Information Worksheet; GSA Form 850
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/08/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/29/2025
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2028	36 Months From Approved	09/30/2025
Responses	22,824	0	25,000
Time Burden (Hours)	5,706	0	6,250
Cost Burden (Dollars)	358,109	0	248,625

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.

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:
	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

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

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

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	22,824	25,000	-2,176
Annual Time Burden (Hours)	5,706	6,250	-544
Annual Cost Burden (Dollars)	358,109	248,625	109,484

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: For Items 12 & 14, an updated estimated # of respondents per year/responses per year was used. This number was calculated by adding the estimated total number of respondents/responses received over the past two fiscal years and then dividing that number by 2 (if necessary, the number was then rounded to the nearest whole number). The change in this number can be attributed to using updated data. Specifically, the updated data reflects estimated data for fiscal years 2024 and 2023, whereas the prior data reflected estimated data for fiscal years 2012 through 2015. For Item 12, an updated estimated cost per hour was used. This number is based on the Office of Personnel Management (OPM) GS-11, Step 10 salary of $46.05 per hour (see OPM Salary Table 2025-RUS, Effective January 2025), plus a fringe factor of 36.25% ($16.69) (see OMB Memo M-08-13 for use in public-private competition). The change can be attributed to using current data (i.e., the previous extension used an amount of $39.78 and mentions using data from fiscal years Fiscal Years 2012-2015. There was no mention of fringe being applied).

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

Agency Contact: Thomas O'Linn 202 445-0390 thomas.olinn@gsa.gov

View ICR - OIRA Conclusion