General Services Administration
Contractor Information Worksheet
OMB Control Number 3090-0283; GSA Form 850
Justification – Part A Supporting Statement
Overview of Information Collection:
This is a request for approval of an extension of an existing information collection.
Information collected through GSA Form 850, Contractor Information Worksheet, is necessary to authorize and initiate background check requests for GSA contractor employees (sometimes referred to as applicants) and for such employees to obtain a GSA access card, if needed. A GSA access card allows a contractor employee to be granted access and work in GSA controlled facilities.
The following are changes of importance that have occurred since the last extension approval:
The total estimated response per year decreased due to the use of updated data. The total estimated responses changed-
From: 25,000
To: 22,824
The total estimated annual public time burden (hours) decreased due to the use of updated data. The total estimated annual public time burden (hours) changed-
From: 6,250
To: 5,706
The total estimated annual time burden (hours) to the Government decreased due to the use of updated data. The total estimated annual cost to the Government changed-
From: 4,000
To: 3,652
1. Need & Method for the Information Collection.
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.
3. Use of Information Technology.
Currently, the only way to collect information is by having the applicant complete the form using black or blue ink or by typing the data in the form and then submitting it. GSA is working to pursue an automated way to receive the information required in the form through the GCIMS.
4. Non-Duplication.
The
information provided on the Contractor Information Worksheet related
to an individual is needed to identify the applicant and contact them
as part of the background check processing by OPM FSC and
credentialing by the MSO. The Contractor Information Worksheet has
some common data fields with Form SF-87, used to capture fingerprints
for the Department of Justice Federal Bureau of Investigation (FBI).
It is needed in order to conduct a FBI National Crime Information
Check (NCIC), also known as the fingerprint check and with two
supplemental forms: Optional Form (OF) 306 and GSA Form 3665. In
addition, the Contractor Information Worksheet requires information
that is not collected on SF-87, OF 306, and GSA Form 3665. The
information not collected on those forms is required to tie
contractors to GSA contracts, buildings, identifying vendor's POC
information, notifying applicants concerning authority to collect
background check related information, Privacy Act routine uses, and
final determination.
5. Burden on Small Business.
The
burden applies equally to both other than small businesses and small
businesses that perform work in GSA controlled facilities. 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 GSA access card will allow a contractor employee to
be granted access and work in GSA controlled facilities.
6. Less Frequent Collection.
Collection of this information is necessary for GSA contractor employees to be granted access and work in GSA controlled facilities and obtain a GSA access card. Without the specific information on the Contractor Information Worksheet, OPM would not be able to identify and contact the applicant and conduct the appropriate background check, thus affecting GSA’s ability to hire contractors to meet the objectives of the OMB HSPD-12 guidance and GSA’s overall security posture. Any alteration of the information to be collected on the Contractor Information Worksheet must be consistent with the terms of agreement in the current Memoranda of Agreement (MOAs) between GSA and OPM and MSO.
7. Paperwork Reduction Act Guidelines.
If OPM FSC identifies any determination issues during the background check, OPM FSC would contact the applicant directly to address those issues. The applicant would then have 15 days to respond to inquiries made by OPM FSC. If the contractor employee fails to submit security documents or respond completely to inquiries made by the OPM FSC within 15 calendar days, the applicant would no longer be considered for an unescorted access determination and the GSA requesting official, applicant, and contracting company will be notified of this decision in writing.
If the result of the applicant’s investigation determination is unfavorable, OPM FSC would provide a written notification to the applicant identifying the specific reasons for proposing to deny the applicant’s participation in the contract due to the unfavorable determination if needed. OPF FSC notifies GSA OMA ICAM Division. ICAM Division will input the results into GCIMS and notify the applicant, GSA sponsor, GSA POCs, and contractor’s point of contact of the unfavorable determination.
8. Consultation and Public Comments.
A 60-day notice was published in the Federal Register at 90 FR 21929 on May 22, 2025. No comments were received.
A 30-day notice was published in the Federal Register at 90 FR 35302 on July 25, 2025. No comments were received.
9. Gifts or Payment.
Not applicable, GSA makes no such payments or gifts to respondents under this information collection.
10. Privacy & Confidentiality.
The Contractor Information Worksheet includes a Privacy Act Notice in compliance with the Privacy Act of 1974, and as authorized by the Federal Property and Administrative Services Act of 1949. The entire notice states: In compliance with the Privacy Act of 1974, the following information is provided: Solicitation of information contained herein may be used as a basis for physical access determinations. GSA describes how your information will be maintained in the Privacy Act system of record notice published in the Federal Register at 73 FR 35690 on June 24, 2008. Your social security number is being requested pursuant to Executive Order 9397. Disclosure of the information by you is voluntary. Failure to provide information requested on this form may result in the government’s inability to grant unescorted physical access to GSA-controlled facilities and may affect your prospects for employment or continued employment under a government contract, or at a Federal facility, or with a government license.
11. Sensitive Questions.
GSA requires the sensitive questions to be answered 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, if applicable. 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 MOAs.
12. Burden Estimate.
The annual estimated total burden hours resulting from this information collection is 5,706 hours. This is based on the following calculation:
Estimated # of respondents (year) 22,824
Estimated # of submissions per respondent x _1
Estimated total # of submissions (year) 22,824
Estimated hours per request x .25 (15 min)
Estimated total burden hours 5,706
Changes Due to Adjustment in Agency Estimate:
An updated estimated # of respondents (year) was used. This updated number is calculated by adding the estimated total number of respondents for fiscal years 2023 and 2024 and then dividing that number by 2. The prior agency estimate used data for fiscal years 2012-2015.
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Burden per Response:
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Annual Burden:
The estimated total annual cost burden to the public is $358,012. This estimate is based on the following calculation:
Estimated # of respondents (year) 22,824 Estimated # of submissions per respondent x 1 Estimated total # of submissions (year) 22,824
Estimated hours per request x .25 (15 min) Estimated total burden hours 5,706
Estimated cost per hour* $62.74 Estimated total annual cost burden to the public $358,012
The estimated cost per submission is approximately $16.00. This number was calculated by dividing the estimated annual cost by the estimated # of submissions (year).
*The estimated cost per hour 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), which results in an hourly rate of $62.74. |
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13. Estimated nonrecurring costs.
Not applicable to this information collection, as respondents do not have to record or maintain the information provided.
14. Estimated cost to the Government.
The estimated total annual cost to the Government is $199,722.
This estimate is based on the following:
Estimated # of responses per year 22,824
Estimated review time per response (hours) x .16 (9.6 minutes)
Total review time per year (hours) 3,652
Estimated cost per hour* x $62.59
Total estimated annual cost to the Government $228,581
*The estimated cost per hour is based on the Office of Personnel Management (OPM) GS-11, Step 5 salary of $45.94 per hour (see OPM Salary Table 2025-DC Area, Effective January 2025), plus a fringe factor of 36.25% ($16.65) (see OMB Memo M-08-13 for use in public-private competition), which results in an hourly rate of $62.59.
15. Reasons for changes.
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).
For Item 14, an updated estimated cost per hour was used. This number is based on the Office of Personnel Management (OPM) GS-11, Step 5 salary of $45.94 per hour (see OPM Salary Table 2025-DC Area, Effective January 2025), plus a fringe factor of 36.25% ($16.65) (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 states it used salary data from Fiscal Year 2014. There was no mention of fringe being applied).
16. Publicizing Results.
Not applicable, the results of this information collection will not be published. Information collected is used for internal purposes only.
17. OMB Not to Display Approval.
Not applicable, GSA is not seeking such approval for this information collection.
18.
Exceptions
to "Certification for Paperwork Reduction Submissions."
Not
applicable, GSA has no exceptions to the certification statement.
19.
Surveys,
Censuses, and Other Collections that Employ Statistical Methods.
Not applicable, Statistical methods are not used for this information collection.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | ThomasO'Linn |
| File Modified | 0000-00-00 |
| File Created | 2025-07-30 |