Fact Sheet Display

Tinker Space-A Travel Request Form


SPACE-A TRAVEL REQUEST
(This form is affected by the Privacy Act of 1974-See below)

This information is required for space available travel registration.   Upon completion, place the upper right corner of this form, and the back of your leave form into the DATE/TIME validator.  Be sure to deposit one copy of this request into the box; retain a copy for the Space Available roll call.  Space A sign-up is good for a 60-day period, or when your leave expires, whichever comes first.  For facsimile (fax) requests, telefax header will establish date/time of sign-up.

 

 

 

2)  RANK/GRADE:  

3) SEATS REQUIRED:   

4)  TRAVEL STATUS (Type of Leave):
CATEGORY I -- Civ or Mil Dependent on Emergency Leave
CATEGORY II -- Environmental Morale Leave (EML)
CATEGORY III -- Active Duty on Ordinary Leave / House Hunting
CATEGORY IV -- (EML) Unaccompanied Dependents
CATEGORY V -- Permissive TDY or TAD / Student Travel / Overseas Command - Sponsored Dependents
CATEGORY VI -- Retired Military / Reserves

FOR OVERSEAS TRAVEL- Boarder Clearance Documents Current?: (See Appendix R)
YES  |  NO

5)  SERVICE:
ARMY  |  NAVY  |  AF  |  MARINES  |  OTHER

6)  DATE LEAVE BEGINS (Active Duty Only):

7)  DATE LEAVE ENDS (if extended, you must notify us before this date):

8) COUNTRY CHOICES (List up to 5; once choice may be all)
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9) LIST NAMES OF DEPENDENTS TRAVELING AND TYPE OF PASSPORT
(
US or Foreign)

 

10)  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 OF 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 RENUMERATION TO MYSELF OR TO MY FAMILY. I UNDERSTAND VIOLATION OF ANY OF THE ABOVE COULD RESULT IN BILLING AND/OR PUNITIVE ACTION.

11)  DATE

PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 8013; EO 9397. 22 November 1943.
PRINCIPAL PURPOSE: To apply for air travel. SSN is needed for positive ID.
ROUTINE USE(S): Records from this system of records may be disclosed for any of the blanket routine uses published by the Air Force.
DISCLOSURE IS VOLUNTARY: Failure to provide the information may result in member not being accepted for travel on military aircraft.
Disclosure of SSN is voluntary.