GSA1364A-1

Simplified Lease Proposal Data

Agency
GSA
Revision
Rev. 11/2016
Fillable fields
71
Pages
3
Official source
GSA form page
Checked
October 20, 2026
Fill GSA1364A-1 online
Page 1 of form GSA1364A-1

GSA Form 1364A-1: Simplified Lease Proposal Data

GSA Form 1364A-1, Simplified Lease Proposal Data, is a three-page General Services Administration (GSA) form, printed as GSA 1364A-1 (REV. 11/2016) with OMB Control Number 3090-0086 and an expiration date of 2/28/2029. GSA hosts it in its forms library, and GSA's page lists APD 2800.12B as its authority or regulation.

The form is filled in response to a numbered Request for Lease Proposals (RLP). Page 1 covers the offeror's interest in the property and checklists on flood plains, seismic safety, historic status, asbestos, fire/life safety, accessibility, ENERGY STAR and a HUBZone price preference waiver. Page 2 breaks the proposed rent into components for office and other space, and page 3 is an addendum of shell definitions.

The form says the information on it is proprietary to the offeror. GSA estimates it will take 2 hours to read the instructions, gather the facts and answer the questions. You can fill it out free in your browser on this page and download the result without an account.

What's on GSA 1364A-1

Items 1 to 4: interest, flood, seismic, historic

The offeror's interest in the property, whether it is in a base (100-year) flood plain, a 500-year flood plain or not in a flood plain, seismic status, and historic property status.

Items 5 to 9: asbestos to HUBZone

Asbestos-containing material, whether the property meets lease fire/life safety and accessibility standards, ENERGY STAR label status or cost effective energy measures, and the HUBZone waiver.

Blocks 10 to 19: proposed rent components

For office area and for other space: building shell rent including real estate taxes, turnkey tenant improvement rent, operating rent, building specific amortized capital rent and a total, in dollars per RSF per year for the firm, non-firm and option terms.

Blocks 20 and 21: costs and interest rates

Tenant improvement costs and building specific amortized capital costs, each with the interest rate used to amortize them.

Blocks 22 to 25: other information and signature

Broker commission information, the proprietary statement, the offeror's agreement to lease upon acceptance, and the signature block.

Page 3: shell definitions

Block 26 lists what the base building and tenant areas include in the shell, such as complete common areas and restrooms, a broom-clean slab, prime painted walls, a suspended ceiling, HVAC and sprinkler mains.

How to complete GSA 1364A-1

  1. 1

    Enter the RLP number and date

    The top of page 1 asks for the Request for Lease Proposals number the form responds to and its date.

  2. 2

    Check the property boxes

    Answer items 1 to 9. Each item points to the RLP section it relates to, and several say to attach appropriate documentation.

  3. 3

    Break down the rent

    Enter each rent component for office area in blocks 10 to 14 and for other space in blocks 15 to 19, in dollars per RSF per year for each term.

  4. 4

    State costs and amortization rates

    Enter tenant improvement costs and building specific amortized capital costs in blocks 20 and 21, each with its amortization interest rate.

  5. 5

    Add broker details if they apply

    If GSA is using an authorized contractor real estate broker, enter both commission rates in block 22 and attach the commission agreement.

  6. 6

    Sign and date

    Sign, print the name and title, and date block 25. Page 3 is a reference addendum of shell definitions.

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Submission, time and what the form says

Where it goes

The PDF gives no submission address. It is filled in response to the numbered Request for Lease Proposals named at the top. The GSA address in the burden statement is for comments on the time estimate only.

Attachments

The form asks for evidence of the offeror's interest in the property and the representative's authority to bind the offeror, appropriate documentation for several items, and the broker commission agreement when one applies.

Proprietary information

Block 23 says the information contained in this 1364A-1, Lease Proposal Data Form, is proprietary to Offeror.

Time to complete

GSA estimates it will take 2 hours to read the instructions, gather the facts and answer the questions.

OMB number

OMB Control Number 3090-0086, expiration date 2/28/2029.

Related forms

Who fills out GSA 1364A-1?

  • The offeror

    The offeror states its interest in the property, fee owner or other, and attaches evidence such as a deed and the representative's authority to bind the offeror.

  • HUBZone small business offerors

    Item 9 lets a HUBZone small business concern offeror elect to waive the price evaluation preference provided in Section 4 of the RLP.

  • The person who signs

    Block 25 has spaces for a signature, name, title and date under the offeror's agreement to lease the premises to the United States of America.

  • Brokers, when GSA uses one

    If GSA is using an authorized contractor real estate broker, block 22 says the offeror must enter the commission rates offered and attach the commission agreement with GSA's Broker.

The form is written for the offeror responding to a Request for Lease Proposals.

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Questions about Form GSA1364A-1

Who issues GSA 1364A-1?

The form is printed as a General Services Administration form, GSA 1364A-1 (REV. 11/2016), with OMB Control Number 3090-0086. GSA hosts it in its forms library and its page lists APD 2800.12B as the authority or regulation.

What rent components does GSA 1364A-1 ask for?

Building shell rent including real estate taxes, turnkey tenant improvement rent, operating rent and building specific amortized capital rent, with a total, for office area and other space, for the firm, non-firm and option terms.

What does the HUBZone item say?

Item 9 says a HUBZone small business concern offeror may elect to waive the price evaluation preference provided in Section 4 of the RLP, and that one desiring to waive it should so indicate on the form.

Is the information on GSA 1364A-1 confidential?

Block 23 says the information contained in this 1364A-1, Lease Proposal Data Form, is proprietary to Offeror.

What is the shell definitions page?

Page 3 is an addendum listing what the base building and tenant areas include in the shell, such as electrical panels providing 4 watts per USF and conditioned air at a rate of .75 cfm per square foot of usable area.

How long does GSA 1364A-1 take to fill out?

GSA estimates 2 hours to read the instructions, gather the facts and answer the questions.