E C = Cancel A = Amend V (Complete Sections A, E, …
Note:1. ACTION code (Indicate one type only)SECTION A - IDENTIFICATIONEACV= Establish= Amend = Cancel = Advance Only (Complete Sections A, E, and F Only)2. AUTHORIZATION DATEMONTHDAYYEAR3. TRAVEL AUTHORIZATION SOCIAL SECURITY NAME (Last)(First)(Middle Initial)6. AGENCY CODE7. AGENCY OON8. TRAVELER OON9. ESTIMATED DATES OF TRAVEL EXPENSESFROMTHRUMonthDayYearMonthDayYear 10. TYPE TRAVEL (Indicate one type only)DMFGFTRTGROCTSOT11. GOVERNMENT CREDIT CARD HOLDERY = YesN = No= Domestic= Foreign= Foreign Transfer= Return Travel= Escorted Group= Outside Cont. Transfer of Station= Outside CONUS ToSSECTION B - EMPLOYMENT STATUS (Check the appropriate employment status block.)12. TRAINING DOCUMENT NO. (For Purpose of Travel code 3 Only)13. OFFICIAL DUTY STATION CITY AND STATE14. RESIDENT CITY AND STATE (If other than official station)SECTION C - ITINERARY AND ESTIMATED EXPENDITURES15.
Note: 1. ACTION CODE (Indicate one type only) SECTION A - IDENTIFICATION E A C V = Establish = Amend = Cancel = Advance Only (Complete Sections A, E, and F Only) 2. AUTHORIZATION DATE
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