DETERMINATION AUTHORIZING USE OF GOVERNMENT PASSENGER CARRIER(S) FOR HOME-TO-WORK TRANSPORTATION PURSUANT TO 41 C.F.R. §102-5 FOR CIRCUMSTANCES THAT CONSTITUTE [SELECT AND INSERT ONE OF THE FOLLOWING]: A CLEAR AND PRESENT DANGER, AN EMERGENCY, OR A COMPELLING OPERATIONAL CONSIDERATION

Determination Control No. (Leave Blank.)

The Administrator makes the following determination and approval of use under 41 C.F.R. §102-5.

1. The following employee(s) or positions of the General Services Administration (GSA), [insert requesting office titles], is/are hereby authorized to use Government -owned, -leased, or - controlled passenger carrier(s) [describe type(s) of carrier(s); e.g. motor vehicle(s), airplane, boat] for transportation between his/her/their residence(s) and place(s) of GSA employment when officially required:

[Insert name(s), and position title(s)]

2. Government passenger carrier transportation is necessary between residence and place of GSA employment for the following reasons:

[Describe the circumstances making Government transportation use necessary]

3. The above-described circumstances are within the meaning of 41 C.F.R. §102-5.

4. Use of Government passenger carriers for home-to-work transportation by the above-listed employee(s) or positions will substantially increase the efficiency and economy of GSA under the circumstances described. The use is not for the personal comfort or convenience of the employee(s).

5. - This determination and approval shall be effective for a period not to exceed 15 consecutive calendar days, beginning with the first day of motor vehicle usage on or about (insert date), and ends fifteen calendar days later, or with the cessation of the event, situation, or circumstance giving rise to the need for carrier use whichever is earlier. This determination may be extended for additional 90-calendar-day periods by a subsequent written determination by the Administrator if the same circumstances underlying this determination and approval continue in existence.

Stephen A. Perry                                                                              Date

Administrator of General Services Administration