Fillable Printable Gs3525
Fillable Printable Gs3525
Gs3525
20a. ACTION
APPROVED
DISAPPROVED
20b. DATES
RECEIVED APP./DISAPP.
21. TYPE OF CUSTOMER AGENCY
CIVILIAN AGENCY
MILITARY
CONTRACTOR
CONGRESSIONAL
(If Contractor/
Congressional, give
expiration date)
22a. SIGNATURE OF GSA APPROVING OFFICIAL
22b. TYPED NAME OF GSA APPROVING OFFICIAL
22c. TITLE 22d. DATE
ADDRESS LOADED
DATE CLERK INITIALS
CATALOG AND CUSTOMER
APPLICATION COPY MAILED
DATE
AREA CODE NUMBER
14b. TYPED NAME OF APPROVING OFFICER 14c. TITLE OF APPROVING OFFICER 14e. DATE
SECTION II - APPLICATION (For GSA use only)
The eligibility of the above-named activity to patronize the GSA Customer Supply Center has been checked and the application
approved or disapproved, as indicated in Item 20a, below.
15. AGENCY BUREAU CODE
(4 digits)
16. STATE CODE (2 digits) 17. CITY CODE (4 digits)
18. CONTRACTOR
19. EXPIRATION DATE (6 digits)
b. OFFICE NAME b. AGENCY NAME
c. STREET ADDRESS c. OFFICE NAME
d. CITY d. STREET ADDRESS
e. STATE f. ZIP CODE e. CITY f. STATE g. ZIP CODE
LINE
NO.
5. ACCESS CODE
(3 to 5 digits)
6. NAME, OFFICE, ETC., PRINTED ON SHIPPING LABEL (Optional)
(Maximum 28 characters. Punctuation and spaces count as characters.)
7. FUND CODE
(2 digits)
8. AGENCY INTERNAL CODE
(6 digits)
1
2
3
4
5
6
7
8
9
9. COST ELEMENT* (3 digits)
10. FUNCTION CODE (2 digits) 11. VDC* (2 digits)
12. PURCHASE CARD USAGE ONLY
CHECK HERE IF APPLICABLE
13. TYPE OF APPLICATION
NEW ADDRESS CHANGE
14a. SIGNATURE OF APPROVING OFFICER
14d. TELEPHONE
APPLICATION FOR CUSTOMER SUPPLY CENTER SERVICES AND ADDRESS CHANGE
IMPORTANT: Read instructions on reverse carefully, before completing this form.
1. ACTIVITY ADDRESS CODE (6 digits)
SECTION I - APPLICATION
2. BILLED OFFICE CODE (6 digits)
3. SHIP TO: (Catalogs sent to this address)
GSA FORM 3525 (REV. 8-95)
Prescribed by FSS P 2901.14
* (GSA ONLY)
GENERAL SERVICES ADMINISTRATION
NOTE: Maximum of 35 characters per block for Agency Name, Office Name, Contact
Name, Street Address, and City. Punctuation and spaces count as characters.
4. BILL TO: (Complete only if different from Item 3.)
a. AGENCY NAME a. CONTACT NAME
INSTRUCTIONS FOR COMPLETING
APPLICATION FOR CUSTOMER SUPPLY CENTER SERVICES
SECTION I - APPLICATION
1. ACTIVITY ADDRESS CODE: Enter your six-digit code used to obtain supplies through the Fedstrip/Milstrip System.
If you do not have a six-digit AAC, please call (703) 305-7977 or write to the Inventory and Requisition Management
Division (FCSI); Washington, DC 20406.
2. BILLED OFFICE CODE: Enter the six-digit code assigned to the activity to which the cost of supplies will be billed. (This
code may be the same as the Activity Address Code, Item 1).
3. SHIP TO ADDRESS: Enter the in-the-clear mailing address of the office to which supplies can be shipped. Address should
correspond with address assigned with Activity Address Code Item 1.
4. BILL TO ADDRESS: Enter the in-the-clear mailing address which corresponds to the code in Item 2.
5. ACCESS CODE: A three to five-digit code assigned by you identifying authorized users to the Customer Supply Center.
This code must be known to place an order, and therefore, provides security against unauthorized usage of the system.
Only approving officials and persons authorized to place orders should have knowledge of the access code. The code can
be any alpha/numeric combination except for the letter "O" or the number "0" (zero).
6. NAME, OFFICE, ETC. ON SHIPPING LABEL: Enter any additional information that may be helpful with internal distribution
of supplies. This entry is optional, but will appear as an "Attention" line on the parcel shipping label, and is also recommended for
multiple users of a single Activity Address Code (e.g., ATTN: Supply Officer).
7. FUND CODE: A two-digit code used by some ordering activities. This block is mandatory and on the absence of an
assigned code will be "00" for civilian applicants. Military customers should record valid Interfund Code. Military
Customers should record "XP" only when they do not wish to be billed through the Interfund or MLSBILLS system.
8. AGENCY INTERNAL CODE: An optional six-digit alpha/numeric code for internal control of billing by a non-GSA customer.
This code, if used, will appear on bi-weekly billing statements and on payroll shipping labels, and is therefore recommended for
multiple users of a single Activity Address Code. This code is a mandatory entry for GSA activities to indicate the
appropriations or revolving fund. A GSA applicant must indicate the three-digit numeric code of the appropriation or revolving
fund that is used for payment. The number indicating the fiscal year of the appropriation or the letter "X" indicating a revolving
fund should not be included in this item. The code for GSA customers should be inserted so that the first position is zero or an
alpha character and fund is in positions 2 through 4.
9. COST ELEMENTS: For GSA NEAR applicants only.
10. FUNCTION CODE: For GSA NEAR applicants only.
11. VDC: The variable data code is for GSA NEAR applicants only.
12. PURCHASE CARD USAGE ONLY: GSA accepts the IMPAC purchase card from everyone. Please check here if your
agency wants to restrict its billing to IMPAC purchase card usage only.
13. TYPE OF APPLICATION: Self-explanatory.
14a.-c. SIGNATURE AND TITLE OF APPROVING OFFICIAL/TELEPHONE NO./DATE: Self-explanatory.
SECTION II - ACTION: For GSA use only.
Upon completion of the application, mail to one of the eleven regions where the Customer Supply Center is located for your
area. Please call the National Help Line at (800) 488-3111 for the address of the CSC that serves your area. After
processing, GSA will mail a copy of the application along with the Customer Supply Center (CSC) Catalog and instructions
for its use, to the address shown in Section I, Item 8. Receipt of this copy is your authorization for center use.
GSA
FORM 3525 BACK (REV. 8-95)
