PR I NT FORM

GPO Form 3001 (R 5/23)

Page 1

14. Cardholder’s Name 16. Email 17. Phone Number 18. GPOExpress

Card Limit

19. Address

15. Cardholder’s Title 20. City, State 21. Zip Code

Participation Request

Renewal: If you are renewing your GPOExpress account(s), check this box and print or 

type your full name and sign at the bottom of this form.

Note: Sections 4-7 do not need to be completed if registering with a credit card.

If you do not want to fill out the above credit card information, please check this box and fill in your name and phone number to speak with a GPO representative.

To name additional cardholders, please continue on page 2.

1.Jacket Number

Name Phone

2. Date

Name on Credit Card

Billing Agency

Cardholder Phone

23. GPOExpress eView Administrator’s Contact Name

26. Financial Contact’s Name

29. Primary Contact’s Name

36. Name of Authorizing Official 37. Authorizing Signature 38. Title of Authorizing Official

32. Address 33. City 34. State 35. Zip

24. eView Administrator’s Telephone Number

27. Financial Contact’s Telephone Number

30. Primary Contact’s Telephone Number

25. eView Administrator’s Email

28. Financial Contact’s Email

31. Primary Contact’s Email

Billing City

Credit Card Number (enter numbers only, no dashes) Expiration Month Year Card Spending Limit per

Credit Card Type

Billing Street

Carholder Email

Billing State Billing Zip Code

5. Requisition Number 6. Billing Address Code (BAC) 7. Agency Location Code (ALC) 8. Line of Accounting (If applicable)

3. Department/Government Establishment 4. Bureau or Office

Required for G-Invoicing (GINV) Must use number as generated by G-Invoicing system 

9. G-INVOICING (GINV) GTC#: 11. ORDER LINE#:

10. GINV ORDER#: 12. ORDER SCHEDULE#:

TAS*: 

Sub-level 

Prefix Code

Allocation 

Transfer 

Agency 

Identifier

Agency 

Identifier

Beginning 

Period of 

Availability

Ending 

Period of 

Availability

Availability 

Type Code

Main 

Account 

Code

Sub-Account 

Code

13. Treasury Account Symbol (TAS) / Business Event Type Code (BETC) BETC*

22. Credit Card Information

I certify that I am an authorized agency representative of the above-mentioned Government establishment with authority to submit this order to the U.S. Government Publishing Office and obligate its 

funding in compliance with applicable regulations, and; this work is authorized by law and necessary to the conduct of the business of the above-mentioned Government establishment.

U.S. GOVERNMENT PUBLISHING OFFICE

732 North Capitol Street, NW | Washington, DC 20401

CLEAR FORM

You may email this form to GPOEXPRESS@gpo.gov 

If you have any questions, please call 202.512.1904
U.S. GOVERNMENT PUBLISHING OFFICE

732 North Capitol Street, NW | Washington, DC 20401

14. Cardholder’s Name 16. Email 17. Phone Number 18. GPOExpress

Card Limit

19. Address

15. Cardholder’s Title 20. City, State 21. Zip Code

Participation Request

1.Jacket Number

2. Date

5. Requisition Number 6. Billing Address Code (BAC) 7. Agency Location Code (ALC) 8. Line of Accounting (If applicable)

3. Department/Government Establishment 4. Bureau or Office

Required for G-Invoicing (GINV) Must use number as generated by G-Invoicing system 

9. G-INVOICING (GINV) GTC#: 10. ORDER LINE#:

11. GINV ORDER#: 12. ORDER SCHEDULE#:

TAS*: 

Sub-level 

Prefix Code

Allocation 

Transfer 

Agency 

Identifier

Agency 

Identifier

Beginning 

Period of 

Availability

Ending 

Period of 

Availability

Availability 

Type Code

Main 

Account 

Code

Sub-Account 

Code

13. Treasury Account Symbol (TAS) / Business Event Type Code (BETC) BETC*

CLEAR FORM PRINT FORM

GPO Form 3001 (R 5/23)

Page 2

You may email this form to GPOEXPRESS@gpo.gov 

If you have any questions, please call 202.512.1904