1
SECTION I — GENERAL INFORMATION (To be completed by employee)
1. NAME OF EMPLOYEE
2. ORGANIZATION CODE
3. SOCIAL SECURITY NUMBER
IF BOX (a)
4. ADDRESS OF RESIDENCE AT TIME OF APPOINTMENT
5. ADDRESS TO WHICH TRAVEL ORDER SHOULD BE MAILED
ABOVE IS
(Street, City, State, ZIP Code)
(If different from item 4)
CHECKED,
COMPLETE
ITEMS 4–8
6. POSITION TO WHICH APPOINTED
7. LOCATION OF POSITION (City, State)
8. PROPOSED EFFECTIVE DATE OF APPOINTMENT
IF BOX (b)
9. CHANGE OF OFFICIAL DUTY STATION (City, State)
10. PROPOSED REPORTING DATE
ABOVE IS
FROM: TO:
AT NEW STATION
CHECKED,
COMPLETE
ITEMS 9–10
SIGNATURE AND TITLE OF APPOINTING OFFICIAL
TELEPHONE NO.
DATE
SECTION II — TRAVEL INFORMATION (To be completed by employee)
The information provided in this section will be used by the Authorizing Official to determine the appropriate allowances to be authorized. If box (a) above is checked, complete
items 11–19 (where applicable). If box (b) above is checked, complete items 11–25 (where applicable).
11a. ADDRESS OF EMPLOYEE’S (OLD) RESIDENCE
11b. DISTANCE FROM OLD
12. IS NEW STATION 50 MILES GREATER THAN THE
RESIDENCE TO OLD
DISTANCE IN 11b? (See FTR 302-2.6)
STATION
❑ YES ❑ NO (If no, do not complete this form.
Relocation allowances are not authorized.)
13. MODE OF TRAVEL FOR WHICH AUTHORIZATION IS REQUESTED (Privately owned vehicle, air, bus, train, etc.)
APPROXIMATE DATE OF
MODE
DEPARTURE POINT
DEPARTURE
ARRIVAL
(a) FOR SELF
(b) FOR IMMEDIATE FAMILY
14.
IF YOU AND YOUR FAMILY WILL TRAVEL SEPARATELY, EXPLAIN
15. NAMES OF IMMEDIATE FAMILY MEMBERS FOR WHOM AUTHORIZATION IS REQUESTED
RELATIONSHIP
CHILDREN’S BIRTH DATE
16. USE OF MORE THAN ONE PRIVATELY OWNED AUTOMOBILE REQUESTED ❑ YES ❑ NO
FORM CD-150 U.S. DEPARTMENT OF COMMERCE
(Rev. 9-03)
PRESCRIBED BY
DOC TRAVEL HANDBOOK
TYPE OF AUTHORIZATION: (Check