Living Quarters Eligibility
Questionnaire; GSA Form 5039
New
collection (Request for a new OMB Control Number)
No
Regular
09/20/2023
Requested
Previously Approved
36 Months From Approved
25
0
25
0
0
0
This information collection activity
concerns an agency-specific form, GSA Form 5039, Living Quarters
Allowance Eligibility Questionnaire. This form would be completed
by job candidates who have been selected for appointment,
reassignment, promotion, or transfer to civil service positions in
foreign areas (i.e., outside the United States and its territories
and possessions). The living quarters allowance is an authority
which allows an agency to reimburse the cost of rent for private
housing in an overseas area. The purpose of the form is to collect
information which is necessary to determine eligibility for this
quarters allowance, under the terms of sections 031.12 and 130 of
the State Department’s Standardized Regulations (DSSR). The
individuals completing this form will be either members of the
public (i.e. not yet appointed to Federal service) or existing
Federal employees already employed by GSA or currently appointed by
a different agency within the Executive Branch of the U.S.
Government.
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:
(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;
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.