Global Positioning Systems

Where in the world are we...

Procedures for Federal Custodian Application Form

For all federal employees who are custodians of the PLGR's, here are some guidelines that must be performed in order for an expeditious process. Below is an example on how to fill out an Federal Custodian Form, along with a brief description of procedures. At the end of this category is a blank form in PDF format downloaded. These forms have been officially approved and cannot be changed or altered in any way or form.

Remember every custodian is obligated to fill out this form before attaining access to the PLGRs. If this is not met, that custodian will refrain from any use of the PLGRs. Also all paperwork must be submitted within 30 days, along with prior notification to the Agency Coordinator, no exceptions. Failure to comply will be grounds for revocations of Custodialship duties and will result in removal from total access to the Federal PPS program.

1. Federal Custodian Form

Applies to Federal employees who are PLGR custodians. Each custodian is required to comply with the following examples and instructions:

1) Section I and II is an example of a fully completed form.

a) Section I reveals Identification of Federal Custodian/User, Identification of Federal Supervision and Identification of Receiver & Storage or Part I, II and III.
b) Section II reveals Certification Statements and Approval or Part IV and V.

2) Part I, II and III:

a) Fill this form out completely leaving nothing blank.
b) Enter N/A (not applicable) in places that don't apply to you.
c) DO NOT send proof of citizenship. Active federal employees have this on file at Personnel. Self-certify your status.
d) State either birth certificate or passport under Type of Proof.
e) There can be several PLGR serial numbers on one application for each custodian.

3) Part IV and V:

a) The GPS Center Coordinator or the GPS Field Station Coordinator must sign and date under Coordinator/Custodian.
b) The custodian must sign and date under Custodian/User.
c) The Property Management Officer or your Supervisor must sign and date under Chief Property Management Officer.

4) The GPS Center Coordinator or the GPS Field Station Coordinator must keep the originals on file.
5) A copy has to be sent to the Agency Coordinator.

NOTES:

1) For all WRD, GD, CBI, COOP,, and NMD custodians, in Part IV under Coordinator/Custodian this where either Theresa Singh or Rick Spengler will sign the original copies and keep them on file.

2) If an individual is born outside the U.S. and their parents are U.S. citizens or has been naturalized as a U.S. citizen, that individual is considered a U.S. citizen.

3) The Agency Coordinator will examine all Federal Custodian Forms and either approve or disapprove each form.

Approved:
Individuals in this group have submitted their forms successfully and no inquiries will be made.

Disapproved:
Individuals in this group have insufficiently completed their form(s). You will be notified about the problem and will have to fax / submit an updated form.

Blank Federal Custodian Application (PDF file)

Please note: PDF versions of of this blank form require version 7.0 of the Adobe Acrobat Reader in order to view them. Users should download a free copy of Acrobat Reader 7.0.

Text-only
Privacy Policy and Disclaimers
Accessibility | FOIA

Comments, questions or suggestions? Send email to: rspengle@usgs.gov