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OMB Control No: 3090-0331	ICR Reference No: 202610-3090-001
Status: Received in OIRA	Previous ICR Reference No: 202309-3090-001
Agency/Subagency: GSA	Agency Tracking No:
Title: Living Quarters Eligibility Questionnaire; GSA Form 5039
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 10/22/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	11/30/2026
Responses	25	25
Time Burden (Hours)	50	25
Cost Burden (Dollars)	0	0

Abstract: The information collected on this form will be used to determine eligibility for the living quarters allowance for foreign areas. The Department of State regulations for this authority require that the employee be recruited from the U.S., or, if already abroad, originally recruited from the U.S. and in continuous employment with the Federal Government overseas with a transportation agreement that establishes an employee’s entitlement to return relocation at the end of the foreign tour of duty. To satisfy this requirement, the job candidate must be able to demonstrate a continuous employment history with the U.S. government overseas as well as an existing transportation agreement with another agency (if transferring to GSA). The job candidate’s employment history will be collected, and the job applicant will sign the GSA Form 5039 certifying to the correctness of the information. The human resources staffing specialists within the Office of Human Resources, as well as the hiring manager, will oversee the collection and recording of the information.

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:
	91 FR 9852	02/27/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 66706	10/22/2026
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Living Quarters Eligibility Questionnaire; GSA Form 5039	GSA 5039

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	25	25	0
Annual Time Burden (Hours)	50	25	25
Annual Cost Burden (Dollars)	0	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: There are three changes: (a) the addition of a definitions section, (b) the addition of a new section discussing State Department regulations in lay-person language, and (c) an increase to the time burden for respondents completing the form. All three changes were due to suggestions from public commenters who we believe have been former respondents of the form and the allowance approval process. They suggested additional information would be a way to provide advice on the form itself, in terms of what information is collected and why it is collected by the agency. The Paperwork Reduction Act burden was also increased because the public commenters said that it takes time to collect attachments that often must be submitted along with the form, or documents that are needed to fill out certain sections of the form.

Annual Cost to Federal Government: $875

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

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