HR Relocation Request Templates

Relocation Request Overseas to Overseas
OMB CONTROL NUMBER: 0702-0131
OMB EXPIRATION DATE: 03/31/2022
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0702-0131, is estimated to
average 30 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:

Relocation Request for Overseas to Overseas

Survey Description:

Time Created:

MM/DD/YYYY XX:XX XM

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Relocation Team

Relocation Request for Overseas to Overseas

* indicates a required field

1. LAST NAME, FIRST NAME, MIDDLE NAME (INCLUDE JR., SR., II, III, ETC) *

2. Last five (5) digits of Social Security Number *

3. Current PB Grade *

4. Current Duty Station *

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5. New Duty Station *

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6. EXACT HOME ADDRESS (STREET/CITY/STATE/ZIP CODE)

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7. HOME PHONE NUMBER (INCLUDE AREA CODE)

8. COMMERCIAL WORK PHONE NUMBER

9. CELL PHONE NUMBER

10. E-MAIL ADDRESS

11. Family Member #1 (full legal name)

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Your relationship to Family Member #1
SON

DAUGHTER
SPOUSE

Family Member #1 Birth Date (DDMMMYYYY)

Will Family Member #1 accompany you to your new duty station at the same time you report?
YES
NO

12. Family Member #2 (full legal name)

Your relationship to Family Member #2
Son

Daughter
Spouse
Other

Family Member #2 Birth Date (DDMMMYYYY)

Will Family Member #2 accompany you to your new duty station when you report

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Relocation Team

Relocation Request for Overseas to Overseas

* indicates a required field

1. LAST NAME, FIRST NAME, MIDDLE NAME (INCLUDE JR., SR., II, III, ETC) *

2. Last five (5) digits of Social Security Number *

3. Current PB Grade *

4. Current Duty Station *

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5. New Duty Station *

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6. EXACT HOME ADDRESS (STREET/CITY/STATE/ZIP CODE)

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7. HOME PHONE NUMBER (INCLUDE AREA CODE)

8. COMMERCIAL WORK PHONE NUMBER

9. CELL PHONE NUMBER

10. E-MAIL ADDRESS

11. Family Member #1 (full legal name)

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Your relationship to Family Member #1
SON
DAUGHTER
SPOUSE

Family Member #1 Birth Date (DDMMMYYYY)

Will Family Member #1 accompany you to your new duty station at the same time you report?
_____YES
_____NO

12. Family Member #2 (full legal name)

Your relationship to Family Member #2
_____Son
_____Daughter
_____Spouse
_____Other

Family Member #2 Birth Date (DDMMMYYYY)

Will Family Member #2 accompany you to your new duty station when you report

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_____No
_____Ship

16. If you are transferring to an overseas location where you cannot drive and want to ship a POV
please provide the make/model/year and VIN number of your vehicle.

17. Associate's Birth Date
(DDMMMYYYY)

18. Actual Place of Residence.
Please list your home of record, city and state. It needs to be a location where you own property or
where your family resides.

EMERGENCY CONTACT: The travel industry now requires you to provide an emergency contact name
and phone number, it needs to be someone who is not travelling with you.

This completes the Questionnaire, please click on the FINISH button when you are through, it will
automatically pop back to me. Don't forget to contact HR Relocation to schedule your PCS OutBriefing AT 214-312-2502.

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COMMENTS/QUESTIONS OR ADDITIONAL INFORMATION:

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Type your question here...
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