Form Link, Living Quarters Allowance (DSSR ) Worksheet (fillable pdf version ). Purpose. This form is to provide domicile and family member information as. Privacy Act Statement: Solicitation of this information is authorized under 5 U.S.C. , E.O. and E.O Section 1(b-2) and DSSR Section. The. Results 1 – 8 FOREIGN ALLOWANCES APPLICATION, GRANT AND REPORT Repair Allowance (DSSR ) LQA – Living Quarters Allowance (DSSR ).

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Block 14 Check the block which represents your request. The purpose of this allowance is to cover, under unusual circumstances, the cost of initial repairs, alterations and improvements which are incurred within 3 months of a rental agreement and which are basic to making the employee’s first permanent residence at a post habitable.

Regardless of any other provisions of these regulations, the head of agency Section e is required to authorize payment of less than the full amount of the LQA or to withhold payment altogether: The living quarters allowance LQA classifications shown in Section are the primary classifications for employees with family WF who have only one member of family Section m and for employees without family WOF.

Enter current Post and Country of Assignment.

Deputy chiefs of diplomatic missions, counselors of diplomatic missions and principal officers of consular establishments may be reimbursed for their allowable quarters costs up to 50 percent more than the LQA prescribed for group 2 for the primary “WF” rate for rssr posts when, in the opinion of the chief of mission, the otherwise applicable LQA rate is insufficient to obtain quarters suitable for providing official entertainment required by the position occupied by such officer. Sign and date the form in Block Rates for Senior Employees in Group 4.

Payment for utilities and if necessary land rent may be continued beyond the 10 year period. At a post classified as follows in column 3, Section The LQA grant to any employee not paid under Section If an agent fee incurred under the specific conditions cited in Section has been advanced or is to be reimbursed to an employee, reimbursement or repayment by the employee within the maximum rate must be prorated over the period covered by the employee’s lease.

A revision in the rate of payment for the last pay period of an annual period or at termination of LQA may be required under provision of Section Don’t list subordinate commands.


The additional amounts of LQA provided by this Section shall not be added to the allowance rate provided under Section Revision shall be from the “with family” rate to the “without dssd rate.

The rate for any split pay period at the end of a calendar year shall be computed at the dssd rate applicable on the first day of that pay period.

An “Estimate” election represents an initial authorization request. When approved by the head of agency as necessary to provide such living quarters, rent may include in addition to the basic annual rental, the cost of: Only the expenses for heat, light, fuel, including gas and electricitywater, garbage and trash disposal and in rare cases land rent, may be added to determine the amount of the employee’s quarters allowance in accordance with Section Where the couple has no additional members of family each employee may be granted the “without family” rate.

The head of agency may allow the payment of the rental portion of the allowance beyond the 10 year period in unusual circumstances and in the best interest of the government.

Employees in quarters group 1 are authorized to be granted up to a maximum of twice the primary “WF” LQA rates prescribed for quarters group 2 for their post if without family or with only one family member, or up to twice the otherwise applicable rate for employees with more than one family member.

CHRA Europe – Overseas

Excel Versions of Per Diem. Despite the provisions of Sections Enter your agency example: If not applicable enter “NA”. Pay Band 1, Pay Band 2.

Cssr “Actual” election is normally utilized during annual reconciliations.

U.S. Department of State

Special Instructions for Completing this Form. No employee shall be granted more than one initial repairs allowance during a period of continuous assignment to a post. The LQA rates are designed to cover substantially all of the average employee’s costs for rent, heat, light, fuel, gas, electricity, water, taxes levied by the local government and required by law or custom to be paid by the lessee, insurance required by local law to be paid by the lessee, and agent’s fee required by law or custom to be paid by lessee.

Government service may be placed in quarters group 3 at essr discretion of head of agency. Army, Air Force, Navy. It is further used to provide actual costs for reconciliation of LQA expenditures.

Before granting the initial repair allowance, the head of agency shall determine that: The other employee may receive fssr “without family” rate.


Thereafter, each employee shall show the actual annual expenses of rent and utilities, supported by receipts or other satisfactory evidence, whenever requested by the officer designated to grant allowances, the Department of State, or other responsible authority.

The following rates of quarters allowances may be granted to married couple employees or domestic partnership employees residing together: The amount of the rental portion of the allowance up to 10 percent of purchase price is limited to a period not to exceed ten years at which time the employee will be entitled only to above utility 10, garbage and trash disposal, plus land rent.

Block 16 Indicate an annual estimated or actual expense as claimed in Block The grade equivalents in the following tables are for purposes of establishing LQA rates only.

If the family does not arrive at the post within 60 consecutive calendar days after commencement of the grant, it shall be revised in accordance with Section Sign ddsr block acknowledging the added statement. If not applicable enter “NA” otherwise enter your spouse’s name, social security number and allowances received examples: This provision is effective as long as the employee remains on grade retention.

When quarters occupied by an employee are owned by the employee or the spouse, or both, or by the employee or the domestic partner, or both, an amount up to 10 percent of original purchase price converted to U.

Purpose This form is to provide domicile and family member information as well as living quarters cost estimates for effecting Living Quarters Allowance LQA payments. If the spouse dssrr domestic partner in the military draws no quarters allowance, the employee may be granted the “with family” rate plus increments for additional members of the family, dssg that no payment shall be made to the spouse or domestic partner of a member of the military service if the employee resides with the member of the military service in Government-owned or -leased quarters.

Employees in this Pay Band who have 15 years of U. Block 13 Employees Name: Block 15 Leave blank. Block 4 Date of Arrival: