Form GSA 7437 GSA 7437 ART IN ARCHITECTURE PROGRAM NATIONAL ARTIST REGISTRY

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ART IN ARCHITECTURE PROGRAM
NATIONAL ARTIST REGISTRY

OMB Control Number: 3090-0274
Expiration Date: XX/XX/20XX

(See Privacy Act Statement Below)

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork
Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The
OMB control number for this collection is 3090-0274. We estimate that it will take 15 minutes to read the instructions, gather the facts, and answer the
questions. Send only comments relating to our time estimate, including suggestions for reducing this burden or any other aspects of this collection of
information, to: U.S. General Services Administration, Regulatory Secretariat Division (MVCB), 1800 F Street, NW, Washington, DC 20405.

INSTRUCTIONS: Return this form with a current résumé and up to 20 digital images of the artist's work created within the last 10 years to
NationalArtistRegistry@GSA.gov. Please use the joint photographic experts group (jpeg) format 10 x 7.5 inches at 200 pixels per inch (PPI).
Please also send a list that provides the title, date, medium/materials, and dimensions for each of the artworks shown in your jpeg images.

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NAME

ARTIST'S WEBSITE

Last

Middle

First

STREET ADDRESS

TELEPHONE NUMBER

STATE

CITY

ZIP CODE

EMAIL ADDRESS

A

U.S. CITIZEN OR
MEDIA (Check as many as apply)
LAWFUL
DRAWING
PAINTING
PERMANENT RESIDENT

YES

NO

OTHER (Specify)

TEXTILE

SCULPTURE

ARCHITECTURAL ARTS

ENVIRONMENTAL ART

PHOTOGRAPHY

PRINT MAKING

TIME-BASED MEDIA

PRIVACY ACT STATEMENT
This information is collected under the general authority granted to GSA under subchapter I of chapter 5 of subtitle I and chapter
33 of subtitle II of title 40 of the United States Code. Providing your name, contact information, resume, and example artwork is
voluntary, however, failure to provide it will prevent us from being able to add an individual to the National Artist Registry for
prospective projects.
The Systems of Records Notice (SORN) which governs the information on this form is the Museum System-TMS, available at:
https://www.federalregister.gov/documents/2022/07/12/2022-14827/privacy-act-of-1974-system-of-records. Information on this
form may be disclosed to a Member of Congress in response to an inquiry made on your behalf. Information may also be
shared with a court or adjudicative body when GSA, or a GSA employee, or the United States is party to litigation and the record
is relevant, necessary, and compatible with the purpose of collecting the information. Finally, information on this form may be
disclosed to an appropriate Federal, State, or local agency responsible for investigating, prosecuting, or enforcing a statute, rule,
regulation or order if GSA becomes aware of any actual or potential violation of a statute, rule or regulation. More information
on this SORN including additional routine uses can be found on GSA’s privacy page, available at:
https://www.gsa.gov/reference/gsa-privacy-program/privacy-policy-and-procedures-guide.

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GENERAL SERVICES ADMINISTRATION

GSA 7437 (REV. XX/20XX)