diff --git a/app/src/app/[locale]/serverAction/actions.ts b/app/src/app/[locale]/serverAction/actions.ts
new file mode 100644
index 00000000..b5bd235a
--- /dev/null
+++ b/app/src/app/[locale]/serverAction/actions.ts
@@ -0,0 +1,29 @@
+"use server";
+
+interface FormDataState {
+  name: string;
+  email: string;
+}
+
+export async function updateServerData(
+  prevState: FormDataState,
+  formData: FormData
+): Promise<FormDataState> {
+  console.log("prevState => ", prevState);
+  console.log("formData => ", formData);
+
+  // With a server form, formData is null and only prevState can be used
+  const name = (formData?.get("name") as string) || prevState.name;
+  const email = (formData?.get("email") as string) || prevState.email;
+
+  // In a real application, you would typically perform
+  // some server mutation.
+  await new Promise((resolve) => setTimeout(resolve, 2000));
+
+  const updatedData: FormDataState = {
+    name: name || prevState.name,
+    email: email || prevState.email,
+  };
+
+  return updatedData;
+}
diff --git a/app/src/app/[locale]/serverAction/clientForm.tsx b/app/src/app/[locale]/serverAction/clientForm.tsx
new file mode 100644
index 00000000..2cb27b99
--- /dev/null
+++ b/app/src/app/[locale]/serverAction/clientForm.tsx
@@ -0,0 +1,65 @@
+"use client";
+
+import { useFormState } from "react-dom";
+
+import { useTranslations } from "next-intl";
+import { Label, TextInput } from "@trussworks/react-uswds";
+
+import SubmitButton from "../../../components/SubmitButton";
+import { updateServerData } from "./actions";
+
+const initialFormState = {
+  name: "",
+  email: "",
+};
+
+export default function ClientForm() {
+  const t = useTranslations("serverAction");
+  const [formData, updateFormData] = useFormState(
+    updateServerData,
+    initialFormState
+  );
+
+  const hasReturnedFormData = formData.name || formData.email;
+
+  return (
+    <>
+      <form action={updateFormData} className="usa-form">
+        <Label htmlFor="name">{t("nameLabel")}</Label>
+        <TextInput
+          id="name"
+          name="name"
+          type="text"
+          defaultValue={formData.name}
+          required
+        />
+        <Label htmlFor="email">{t("emailLabel")}</Label>
+        <TextInput
+          id="email"
+          name="email"
+          type="email"
+          defaultValue={formData.email}
+          className="margin-bottom-1"
+          required
+        />
+        <SubmitButton />
+      </form>
+
+      {hasReturnedFormData && (
+        <div className="margin-top-4">
+          <h2>{t("returnedDataHeader")}</h2>
+          {formData.name && (
+            <div>
+              <strong>{t("nameLabel")}:</strong> {formData.name}
+            </div>
+          )}
+          {formData.email && (
+            <div>
+              <strong>{t("emailLabel")}:</strong> {formData.email}
+            </div>
+          )}
+        </div>
+      )}
+    </>
+  );
+}
diff --git a/app/src/app/[locale]/serverAction/page.tsx b/app/src/app/[locale]/serverAction/page.tsx
new file mode 100644
index 00000000..e71d362e
--- /dev/null
+++ b/app/src/app/[locale]/serverAction/page.tsx
@@ -0,0 +1,47 @@
+// Server Action example
+// For more context: https://nextjs.org/docs/app/building-your-application/data-fetching/server-actions-and-mutations
+
+import { pick } from "lodash";
+import { Metadata } from "next";
+
+import {
+  NextIntlClientProvider,
+  useMessages,
+  useTranslations,
+} from "next-intl";
+import { getTranslations } from "next-intl/server";
+
+import ClientForm from "./clientForm";
+
+interface RouteParams {
+  locale: string;
+}
+
+export async function generateMetadata({ params }: { params: RouteParams }) {
+  const t = await getTranslations({ locale: params.locale });
+  const meta: Metadata = {
+    title: t("serverAction.title"),
+  };
+
+  return meta;
+}
+
+interface Props {
+  params: RouteParams;
+}
+
+export default function SimpleForm({ params }: Props) {
+  const { locale } = params;
+  const messages = useMessages();
+  const t = useTranslations("serverAction");
+
+  return (
+    <NextIntlClientProvider
+      locale={locale}
+      messages={pick(messages, "serverAction")}
+    >
+      <h1>{t("title")}</h1>
+      <ClientForm />
+    </NextIntlClientProvider>
+  );
+}
diff --git a/app/src/components/FormInput.tsx b/app/src/components/FormInput.tsx
new file mode 100644
index 00000000..58d73c38
--- /dev/null
+++ b/app/src/components/FormInput.tsx
@@ -0,0 +1,34 @@
+"use client";
+
+import { Label, TextInput } from "@trussworks/react-uswds";
+
+interface FormInputProps {
+  id: string;
+  name: string;
+  type: "number" | "search" | "text" | "email" | "password" | "tel" | "url";
+  label: string;
+  defaultValue?: string;
+}
+
+const FormInput: React.FC<FormInputProps> = ({
+  id,
+  name,
+  type,
+  label,
+  defaultValue,
+}) => {
+  return (
+    <>
+      <Label htmlFor={id}>{label}</Label>
+      <TextInput
+        id={id}
+        name={name}
+        type={type}
+        defaultValue={defaultValue}
+        className="margin-bottom-1"
+      />
+    </>
+  );
+};
+
+export default FormInput;
diff --git a/app/src/components/SubmitButton.tsx b/app/src/components/SubmitButton.tsx
new file mode 100644
index 00000000..f10f11c6
--- /dev/null
+++ b/app/src/components/SubmitButton.tsx
@@ -0,0 +1,19 @@
+"use client";
+
+import { useFormStatus } from "react-dom";
+
+import { useTranslations } from "next-intl";
+import { Button } from "@trussworks/react-uswds";
+
+function SubmitButton() {
+  const t = useTranslations("serverAction");
+  const { pending } = useFormStatus();
+
+  return (
+    <Button type="submit" disabled={pending}>
+      {pending ? t("submitting") : t("submit")}
+    </Button>
+  );
+}
+
+export default SubmitButton;
diff --git a/app/src/i18n/messages/en-US/index.ts b/app/src/i18n/messages/en-US/index.ts
index 5e856e07..0993602d 100644
--- a/app/src/i18n/messages/en-US/index.ts
+++ b/app/src/i18n/messages/en-US/index.ts
@@ -26,4 +26,13 @@ export const messages = {
     formatting:
       "The template includes an internationalization library with basic formatters built-in. Such as numbers: { amount, number, currency }, and dates: { isoDate, date, long}.",
   },
+  serverAction: {
+    title: "Server Actions Example",
+    submitting: "Submitting...",
+    submit: "Submit",
+    nameLabel: "Name",
+    emailLabel: "Email",
+    submitLabel: "Submit",
+    returnedDataHeader: "Server Action returned data",
+  },
 };