HR Relocation Request Templates

Household Goods Request
OMB CONTROL NUMBER: 0702-0131
OMB EXPIRATION DATE: XX/XX/XXXX
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0702-0131, is estimated to
average 45 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments regarding the burden estimate or
burden reduction suggestions to the Department of Defense, Washington Headquarters
Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil.
Respondents should be aware that notwithstanding any other provision of law, no person
shall be subject to any penalty for failing to comply with a collection of information if it
does not display a currently valid OMB control number.
PRIVACY ACT STATEMENT
AUTHORITY: Title 10 U.S.C. 7013, Secretary of the Army; Title 10 U.S.C. 9013,
Secretary of the Air Force; Army Regulation 215-1, The Administration of Morale,
Welfare, and Recreation Activities and Non-appropriated Fund Instrumentalities; Army
Regulation 215-8/AFI 34-211(I), Army and Air Force Exchange Service Operations; and
E.O. 9397 (SSN), as amended.
PRINCIPAL PURPOSE(S): To process official travel requests for civilian employees of
the Army and Air Force Exchange Service; to determine eligibility of individual's
dependents to travel; to obtain necessary clearance where foreign travel is involved,
including assisting individual in applying for passports and visas and counseling where
proposed travel involves visiting/transiting communist countries and danger zones.
ROUTINE USE(S): Your records may be disclosed outside of DoD pursuant to Title 5
U.S.C. §552a(b)(3) regarding DoD “Blanket Routine Uses” published at
http://dpcld.defense.gov/Privacy/SORNsIndex/BlanketRoutineUses.aspx. This may
include disclosures to the attaché or law enforcement authorities of foreign countries, the
U.S. Department of Justice or Department of Defense legal/intelligence/investigative
agencies for security, investigative, intelligence, and/or counterintelligence operations.
DISCLOSURE: Voluntary, however failure to provide all the information needed my
result in denial of your PCS orders.
A copy of the Privacy Impact Assessment (PIA) for this collection may be located at
http://www.aafes.com/about-exchange/public-affairs/FOIA/assessments.htm.

INSTRUCTIONS
1. Please read the above Agency Disclosure Notice and Privacy Act Statement prior to
responding below to review, complete, and answer the following questions.
2. In order to provide you with appropriate orders, each question must be
answered.
3. When you have completed the request form, press the submit button and your
information will be automatically forwarded to the Exchange authorized HR travel
associates for completion of your PCS orders.
4. All approved signatures will be obtained by the HR representative.
5. You will be provided a copy of your final approved PCS orders.
6. If you have questions, concerns, or need more information, please see your HR
manager.

Respond

Survey Name:

Household Goods Request

Survey Description:

Time Created:

MM/DD/YYYY XX:XX XM

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Relocation Team

Household Goods Request
* indicates a required field

PLEASE READ BEFORE COMPLETING THE SURVEY
HOUSEHOLD GOODS (HHG). The maximum weight limit for HHG is 18,000 lbs. If the weight of your
HHG exceeds the authorized weight limit, you will receive notice from the Exchange/AAFES regarding
repayment for the excess amount. Typically, you should pack HHG’s two weeks prior to reporting to
your new duty station unless circumstances warrant otherwise (for example, going to a foreign
overseas location).
FOREIGN TRANSFER ALLOWANCES (FTA). Associates who are transferring to a foreign overseas
location are authorized to stay in temporary lodging (hotel) up to 10 days before departure. Please
plan your HHG pack out and airline reservations accordingly.
POINT OF CONTACT. The POC for HHG, Non-Temporary Storage and Unaccompanied Baggage
shipments is The Relocation Team at 214-312-2502.
Please answer the questions in order for us to set up your move. Once you complete this
questionnaire, click on the FINISH tab.

1. Last name, First name, Middle name (include Jr, Sr, II, III, etc.) *

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2. Last five (5) digits of your SSN *

3. Your Y Number (TSS id) *

4. Your Current Grade *

5. Number of Family Members (Dependents) *

6. Report Date (DDMMMYYYY) *

7. Current Duty Station (Address & Facility #) example: Beale AFB, Marysville, CA 95903 Fac# 4793 *

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estimated WEIGHT in lbs. you will be storing. Please include all applicable dates.
Input N/A if you do not need to store anything. *

25. Unaccompanied Baggage (Overseas Moves Only) what is your requested pack/pick-up date?
(DDMMMYYYY) Input N/A if you will not be shipping. *

Unaccompanied Baggage Shipment is restricted to 350 lbs. (over 12 yrs old) and 175 lbs. (under 12
yrs old). Maximum authorized weight is 1,000 lbs.
In lieu of shipping unaccompanied baggage, you can:
1. Mail items or
2. Take two (2) extra pieces of luggage on the plane (per family).
NOTE: Both options above need prior approval by the Relocation Team at 214-312-2502. *

26. Provide your internet email address(s) *

27. If you have a moving company you prefer please let us know by typing the company name in the
block. If possible we will try and accomodate your request. Unfortunately, you cannot select for
overseas moves.

Since your move is booked through this office, please notify us of any changes ASAP so your
paperwork and Relo File can be updated.
Please provide any additional comments at this time.

Please stop here and select the FINISH tab to complete your form.

STOP - PLEASE DO NOT CONTINUE - THE FOLLOWING WILL BE COMPLETED BY THE HQ RELOCATION
OFFICE.
GBL Number

CODE

Origin Area

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Destination Area

Mileage/Schedule

Carrier SCAC
Shipment Awarded To

Booking Agent and Phone Number

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Date Sent to Booking Agent (DDMMMYYYY)

Destination Agent/T.O.

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Comments

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