Space Available Travel Request

Subject:  Remote Space-A Signup

Last Name: self explanatory
First Name: self explanatory
Middle Initial: self explanatory
Rank or Grade: self explanatory
SSAN: last 4 numbers only (per the reg, disclosure of SSAN is voluntary until you arrive at the terminal)

Branch of Service: USAF or USA, or USN or USMC etc…..
Number of Seats Required: enter total number of passengers
Travel Status (type of leave): self explanatory (Cat-III, Cat-VI etc….)
Date Leave Begins (Active Duty Only): self explanatory

Date Leave Ends (Active Duty Only): self explanatory

Border Clearance Documents Current?: Yes (assuming you have all necessary passports and visas)
Country Choices: List up to five; one choice may be ALL, e.g. Germany, England, USA)
Names of Dependent's Traveling and Type of Passport:  (e.g. passport type is USA, Irish, German etc..)

Email Address: self explanatory
Telephone Number: self explanatory

I certify that I am on leave or pass status at the time I register for space available travel and will remain in such status when awaiting and/or have been accepted for space available travel. If accompanied by dependents, I further certify that my travel is not in conjunction with TDY/TAD and that I am not using space available travel to transport my dependents to or from my restricted duty station or all others (unaccompanied) tour location station. I certify that my request for, and acceptance of, transportation via DOD-owned or controlled aircraft is not for personal gain, nor for, or in connection with business of any nature and that this trip will not result in any form of remuneration to myself or my family. I understand violation of any of the above could result in billing and/or punitive action.

Date: YYYYMMDD

Signature:  Initials