Doe F 551.1 Doe Request For Approval Of Foreign Travel

DOE F 551.1

Traveler Name:                   

U.S. DEPARTMENT OF ENERGY

REQUEST FOR APPROVAL OF FOREIGN TRAVEL

This form is provided as a convenience for the collection of Foreign Travel Request data. The form is intended for use as an offline resource to collect data necessary to support the Foreign Travel Management System (FTMS). Completion of the form is not considered sufficient in itself for satisfying DOE Order 551.1A, the data must still be entered into the FTMS for Department of Energy (DOE) tracking and monitoring. Specific questions on Foreign Travel or the completion of this form should be directed to your sites Senior FTMS Organizational Point of Contact (Sr. OPOC).

OMB Burden Disclosure Statement

Public reporting burden for this collection of information is estimated to average 15 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 this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Office of the Chief Information Officer, Records Management Division, IM-11, Paperwork Reduction Project (1910-5144), U.S. Department of Energy, 1000 Independence Ave SW, Washington, DC, 20585-1290; and to the Office of Management and Budget (OMB), OIRA, Paperwork Reduction Project (1910-5144), Washington, DC 20503

This form may be completed on your computer. Press TAB to jump from one field to the next.

Section I – Traveler Information (to be completed by Traveler)
1. Program Office      								1a. If Program Office is within NNSA, provide a PNTR number      
2. Last Name      					First Name      			Middle Name or NMN      
3. Do you have an SSN?   Yes No Last 4 digits of SSN (ex.xxx-xx-6789) ►													    
4. Passport Type						Passport Number			Expiration Date (mm/dd/yyyy)			Used for Trip?
1		Regular Official Diplomatic				     			            
2		Regular Official Diplomatic				     			            
3		Regular Official Diplomatic				     			            
5. Gender:     Male Female							6. Birth Place Country:          
7. Citizenship:							8. Permanent Resident Green Card Holder?
(1)			     				Yes No
(2)			     
9. DOE Facility/Organization Non-editable field that defaults to the site to which you are logged in. If the traveler does not work for DOE, provide further details about their employer in the Employee Type field.							13. Employee Type: DOE Federal Employee Other Federal Employee Contractor Foreign National University Invitational Traveler If non-DOE specify the name of the employer:      
10. Local Organization/Department      
11. Local Facility:      
12. Local ID:       
14. Employment Address
Street Address				     
				     
City       State          ZIP Code         Country        
15. Contact Information
Phone Type										Phone Number (domestic example: 703-555-5555)
1	Work Phone   Work Fax   Home Phone   Domestic Cell   International Cell									     
2	Work Phone   Work Fax   Home Phone   Domestic Cell   International Cell									     
3	Work Phone   Work Fax   Home Phone   Domestic Cell   International Cell									     
4	Work Phone   Work Fax   Home Phone   Domestic Cell   International Cell									     
5	Work Phone   Work Fax   Home Phone   Domestic Cell   International Cell									     
e-mail Address:											Primary Address (for password reset; check only one)
     
     
     
16. Position/Title         
17. Indicate whether you have a security clearance.    Yes No If yes, indicate highest level received:      Top Secret Secret Q L Other
18. Notes to other OPOCs.      

Section II – General Trip Information (to be completed by Traveler)
Use additional general trip information pages as required. Account for all funding types estimated for this trip request.
19. Place of Departure (City, State/Province, Country)      								20. Departure Date (mm/dd/yyyy)             
								21. Return Date (mm/dd/yyyy)             
22. Estimated travel costs by funding type
Primary Sponsor	Funding Type		Program Office	Project No.	Task No.	Funding Code	Title		Estimated Airfare		Estimated Other
	DOE Non-DOE Foreign DOE Overhead Salary		    	     	     	     	     		     		     
	DOE Non-DOE Foreign DOE Overhead Salary		    	     	     	     	     		     		     
	DOE Non-DOE Foreign DOE Overhead Salary		    	     	     	     	     		     		     
	DOE Non-DOE Foreign DOE Overhead Salary		    	     	     	     	     		     		     
23. Type of Travel: Airfare – Coach Train – Coach Vehicle Rental – Premium None Airfare – Premium Train – Premium Vehicle – Privately Owned Carrier Name       Flight Number       Departure Point       Departure Date              Departure Time   :   AM PM Arrival Point       Arrival Date              Arrival Time   :   AM PM Type of Travel Airfare – Coach Train – Coach Vehicle Rental – Premium None Airfare – Premium Train – Premium Vehicle – Privately Owned Carrier Name       Flight Number       Departure Point       Departure Date              Departure Time   :   AM PM Arrival Point       Arrival Date              Arrival Time   :   AM PM (Additional entries are available at the end of this form.)
24. Give justification of premium travel:      
25. Names and Organizations of Headquarters personnel with whom trip has been coordinated
Org. Code		Contact Name
    		     
    		     
    		     
26. Names and Organizations of other personnel with whom you are traveling as a team:      
27. Benefit to Government (include benefit to present position and the Department):      
28. Type of Assignment Temporary Duty Permanent Change of Station Temporary Change of Station Transfers to International Organizations Cost Fee Expert
29. Comments
General comments regarding trip request:      
Specify any paper attachments to this form:      
Place of return (if not the same as the departure city) and reason:      
30. Field TR (Reference) Number      
31. Has the traveler contacted his/her Medical Support Staff to ensure awareness of safety and health issues of the country(ies) to be visited?										Yes No
Comments (1000 characters max.)      
32. Will the traveler be taking DOE or Laboratory owned equipment on this travel?										Yes No
Comments (1000 characters max.)      

Itinerary 1

Section III – Trip Itinerary (to be completed by Traveler)
Use additional itinerary pages as required. Account for the entire time between departure and return. Complete a separate itinerary for each city/country to be visited and for each personal or leave period.
33a. Is this part of the trip associated with a conference? If yes, specify conference name, start and end dates, country-city of the conference, and the conference URL below (if known).									Yes No
33b. Will anyone from a DOE-designated sensitive country be in attendance at this conference?									Yes No Unknown
Conference Name      							Conference URL (if known)      
34. Destination Country-City      
35. Start Date (mm/dd/yyyy)             							36. End Date (mm/dd/yyyy)             
37a. Select One or More Primary Purpose(s):
Professional conference or workshop Seminar/Symposium Working group or colloquia (scientific meeting) Site Visit R and D activities under an informal lab‑to‑lab or government-to-government agreement Meeting(s) on scientific, technical, project, or programmatic matters					Procurement-related matters Official Stop Over Personal Leave IAEA Travel LDRD Project Work Permanent Change of Station Other(s)
If Personal Leave, enter any additional information (dates, contacts, etc.):      
37b. List other primary purpose:      
38. Justify Trip Purpose (i.e. topics to be discussed, formal presentation, or paper):      
This part of the trip involves:
39.	Yes No	Lab-to-Lab agreement?
40.	Yes No	University-to-Lab agreement?
41.	Yes No	International agreement? If yes, enter agreement name:      
42.	Yes No	Will classified information be discussed?
43.	Yes No	Will you be interacting with anyone from a DOE-designated sensitive country?
44.	Yes No	Does this Itinerary involve training?
45.	Yes No	Will any part of the trip discuss sensitive subjects as defined by DOE’s Sensitive Subject List?
46.	Yes No	Will any part of the trip involve information that is subject to U.S. Export Control restrictions? If yes, please provide details.      
47.	Yes No	Meetings with senior government official(s)? Provide official's name, position, and contact information. Describe meeting goals.      
48. Embassy Assistance
Does the traveler require the post to arrange lodging accommodations? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require the post to arrange airport assistance or transportation? Please describe: (Please do not exceed 2000 characters.)      
Will the traveler be traveling with an accompanying pouch? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require an appointment with someone? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require any other assistance? Please describe: (Please do not exceed 2000 characters.)      
Fiscal Data: Please describe: (Please do not exceed 2000 characters.)      
Any Other Comments/Remarks: Please describe: (Please do not exceed 4000 characters.)      
49. Contacts
Host Name				Host Phone		Affiliated Institution		Facility to be Visited		Date Visited
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
Hotel/Lodging Name			Hotel/Lodging Phone				Hotel/Lodging Name		Hotel/Lodging Phone
     			     				     		     
     			     				     		     
     			     				     		     

Itinerary 2

Section III – Trip Itinerary (to be completed by Traveler)
Use additional itinerary pages as required. Account for the entire time between departure and return. Complete a separate itinerary for each city/country to be visited and for each personal or leave period.
33a. Is this part of the trip associated with a conference? If yes, specify conference name, start and end dates, country-city of the conference, and the conference URL below (if known).									Yes No
33b. Will anyone from a DOE-designated sensitive country be in attendance at this conference?									Yes No Unknown
Conference Name      							Conference URL (if known)      
34. Destination Country-City      
35. Start Date (mm/dd/yyyy)             							36. End Date (mm/dd/yyyy)             
37a. Select One or More Primary Purpose(s):
Professional conference or workshop Seminar/Symposium Working group or colloquia (scientific meeting) Site Visit R and D activities under an informal lab‑to‑lab or government-to-government agreement Meeting(s) on scientific, technical, project, or programmatic matters					Procurement-related matters Official Stop Over Personal Leave IAEA Travel LDRD Project Work Permanent Change of Station Other(s)
If Personal Leave, enter any additional information (dates, contacts, etc.):      
37b. List other primary purpose:      
38. Justify Trip Purpose (i.e. topics to be discussed, formal presentation, or paper):      
This part of the trip involves:
39.	Yes No	Lab-to-Lab agreement?
40.	Yes No	University-to-Lab agreement?
41.	Yes No	International agreement? If yes, enter agreement name:      
42.	Yes No	Will classified information be discussed?
43.	Yes No	Will you be interacting with anyone from a DOE-designated sensitive country?
44.	Yes No	Does this Itinerary involve training?
45.	Yes No	Will any part of the trip discuss sensitive subjects as defined by DOE’s Sensitive Subject List?
46.	Yes No	Will any part of the trip involve information that is subject to U.S. Export Control restrictions? If yes, please provide details.      
47.	Yes No	Meetings with senior government official(s)? Provide official's name, position, and contact information. Describe meeting goals.      
48. Embassy Assistance
Does the traveler require the post to arrange lodging accommodations? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require the post to arrange airport assistance or transportation? Please describe: (Please do not exceed 2000 characters.)      
Will the traveler be traveling with an accompanying pouch? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require an appointment with someone? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require any other assistance? Please describe: (Please do not exceed 2000 characters.)      
Fiscal Data: Please describe: (Please do not exceed 2000 characters.)      
Any Other Comments/Remarks: Please describe: (Please do not exceed 4000 characters.)      
49. Contacts
Host Name				Host Phone		Affiliated Institution		Facility to be Visited		Date Visited
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
Hotel/Lodging Name			Hotel/Lodging Phone				Hotel/Lodging Name		Hotel/Lodging Phone
     			     				     		     
     			     				     		     
     			     				     		     

Itinerary 3

Section III – Trip Itinerary (to be completed by Traveler)
Use additional itinerary pages as required. Account for the entire time between departure and return. Complete a separate itinerary for each city/country to be visited and for each personal or leave period.
33a. Is this part of the trip associated with a conference? If yes, specify conference name, start and end dates, country-city of the conference, and the conference URL below (if known).									Yes No
33b. Will anyone from a DOE-designated sensitive country be in attendance at this conference?									Yes No Unknown
Conference Name      							Conference URL (if known)      
34. Destination Country-City      
35. Start Date (mm/dd/yyyy)             							36. End Date (mm/dd/yyyy)             
37a. Select One or More Primary Purpose(s):
Professional conference or workshop Seminar/Symposium Working group or colloquia (scientific meeting) Site Visit R and D activities under an informal lab‑to‑lab or government-to-government agreement Meeting(s) on scientific, technical, project, or programmatic matters					Procurement-related matters Official Stop Over Personal Leave IAEA Travel LDRD Project Work Permanent Change of Station Other(s)
If Personal Leave, enter any additional information (dates, contacts, etc.):      
37b. List other primary purpose:      
38. Justify Trip Purpose (i.e. topics to be discussed, formal presentation, or paper):      
This part of the trip involves:
39.	Yes No	Lab-to-Lab agreement?
40.	Yes No	University-to-Lab agreement?
41.	Yes No	International agreement? If yes, enter agreement name:      
42.	Yes No	Will classified information be discussed?
43.	Yes No	Will you be interacting with anyone from a DOE-designated sensitive country?
44.	Yes No	Does this Itinerary involve training?
45.	Yes No	Will any part of the trip discuss sensitive subjects as defined by DOE’s Sensitive Subject List?
46.	Yes No	Will any part of the trip involve information that is subject to U.S. Export Control restrictions? If yes, please provide details.      
47.	Yes No	Meetings with senior government official(s)? Provide official's name, position, and contact information. Describe meeting goals.      
48. Embassy Assistance
Does the traveler require the post to arrange lodging accommodations? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require the post to arrange airport assistance or transportation? Please describe: (Please do not exceed 2000 characters.)      
Will the traveler be traveling with an accompanying pouch? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require an appointment with someone? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require any other assistance? Please describe: (Please do not exceed 2000 characters.)      
Fiscal Data: Please describe: (Please do not exceed 2000 characters.)      
Any Other Comments/Remarks: Please describe: (Please do not exceed 4000 characters.)      
49. Contacts
Host Name				Host Phone		Affiliated Institution		Facility to be Visited		Date Visited
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
Hotel/Lodging Name			Hotel/Lodging Phone				Hotel/Lodging Name		Hotel/Lodging Phone
     			     				     		     
     			     				     		     
     			     				     		     

Itinerary 4

Section III – Trip Itinerary (to be completed by Traveler)
Use additional itinerary pages as required. Account for the entire time between departure and return. Complete a separate itinerary for each city/country to be visited and for each personal or leave period.
33a. Is this part of the trip associated with a conference? If yes, specify conference name, start and end dates, country-city of the conference, and the conference URL below (if known).									Yes No
33b. Will anyone from a DOE-designated sensitive country be in attendance at this conference?									Yes No Unknown
Conference Name      							Conference URL (if known)      
34. Destination Country-City      
35. Start Date (mm/dd/yyyy)             							36. End Date (mm/dd/yyyy)             
37a. Select One or More Primary Purpose(s):
Professional conference or workshop Seminar/Symposium Working group or colloquia (scientific meeting) Site Visit R and D activities under an informal lab‑to‑lab or government-to-government agreement Meeting(s) on scientific, technical, project, or programmatic matters					Procurement-related matters Official Stop Over Personal Leave IAEA Travel LDRD Project Work Permanent Change of Station Other(s)
If Personal Leave, enter any additional information (dates, contacts, etc.):      
37b. List other primary purpose:      
38. Justify Trip Purpose (i.e. topics to be discussed, formal presentation, or paper):      
This part of the trip involves:
39.	Yes No	Lab-to-Lab agreement?
40.	Yes No	University-to-Lab agreement?
41.	Yes No	International agreement? If yes, enter agreement name:      
42.	Yes No	Will classified information be discussed?
43.	Yes No	Will you be interacting with anyone from a DOE-designated sensitive country?
44.	Yes No	Does this Itinerary involve training?
45.	Yes No	Will any part of the trip discuss sensitive subjects as defined by DOE’s Sensitive Subject List?
46.	Yes No	Will any part of the trip involve information that is subject to U.S. Export Control restrictions? If yes, please provide details.      
47.	Yes No	Meetings with senior government official(s)? Provide official's name, position, and contact information. Describe meeting goals.      
48. Embassy Assistance
Does the traveler require the post to arrange lodging accommodations? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require the post to arrange airport assistance or transportation? Please describe: (Please do not exceed 2000 characters.)      
Will the traveler be traveling with an accompanying pouch? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require an appointment with someone? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require any other assistance? Please describe: (Please do not exceed 2000 characters.)      
Fiscal Data: Please describe: (Please do not exceed 2000 characters.)      
Any Other Comments/Remarks: Please describe: (Please do not exceed 4000 characters.)      
49. Contacts
Host Name				Host Phone		Affiliated Institution		Facility to be Visited		Date Visited
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
Hotel/Lodging Name			Hotel/Lodging Phone				Hotel/Lodging Name		Hotel/Lodging Phone
     			     				     		     
     			     				     		     
     			     				     		     

Itinerary 5

Section III – Trip Itinerary (to be completed by Traveler)
Use additional itinerary pages as required. Account for the entire time between departure and return. Complete a separate itinerary for each city/country to be visited and for each personal or leave period.
33a. Is this part of the trip associated with a conference? If yes, specify conference name, start and end dates, country-city of the conference, and the conference URL below (if known).									Yes No
33b. Will anyone from a DOE-designated sensitive country be in attendance at this conference?									Yes No Unknown
Conference Name      							Conference URL (if known)      
34. Destination Country-City      
35. Start Date (mm/dd/yyyy)             							36. End Date (mm/dd/yyyy)             
37a. Select One or More Primary Purpose(s):
Professional conference or workshop Seminar/Symposium Working group or colloquia (scientific meeting) Site Visit R and D activities under an informal lab‑to‑lab or government-to-government agreement Meeting(s) on scientific, technical, project, or programmatic matters					Procurement-related matters Official Stop Over Personal Leave IAEA Travel LDRD Project Work Permanent Change of Station Other(s)
If Personal Leave, enter any additional information (dates, contacts, etc.):      
37b. List other primary purpose:      
38. Justify Trip Purpose (i.e. topics to be discussed, formal presentation, or paper):      
This part of the trip involves:
39.	Yes No	Lab-to-Lab agreement?
40.	Yes No	University-to-Lab agreement?
41.	Yes No	International agreement? If yes, enter agreement name:      
42.	Yes No	Will classified information be discussed?
43.	Yes No	Will you be interacting with anyone from a DOE-designated sensitive country?
44.	Yes No	Does this Itinerary involve training?
45.	Yes No	Will any part of the trip discuss sensitive subjects as defined by DOE’s Sensitive Subject List?
46.	Yes No	Will any part of the trip involve information that is subject to U.S. Export Control restrictions? If yes, please provide details.      
47.	Yes No	Meetings with senior government official(s)? Provide official's name, position, and contact information. Describe meeting goals.      
48. Embassy Assistance
Does the traveler require the post to arrange lodging accommodations? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require the post to arrange airport assistance or transportation? Please describe: (Please do not exceed 2000 characters.)      
Will the traveler be traveling with an accompanying pouch? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require an appointment with someone? Please describe: (Please do not exceed 2000 characters.)      
Does the traveler require any other assistance? Please describe: (Please do not exceed 2000 characters.)      
Fiscal Data: Please describe: (Please do not exceed 2000 characters.)      
Any Other Comments/Remarks: Please describe: (Please do not exceed 4000 characters.)      
49. Contacts
Host Name				Host Phone		Affiliated Institution		Facility to be Visited		Date Visited
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
     				     		     		     		            
Hotel/Lodging Name			Hotel/Lodging Phone				Hotel/Lodging Name		Hotel/Lodging Phone
     			     				     		     
     			     				     		     
     			     				     		     

24. Additional Types of Travel
	Type of Travel: Airfare – Coach Train – Coach Vehicle Rental – Premium None Airfare – Premium Train – Premium Vehicle – Privately Owned Carrier Name       Flight Number       Departure Point       Departure Date              Departure Time   :   AM PM Arrival Point       Arrival Date              Arrival Time   :   AM PM Type of Travel Airfare – Coach Train – Coach Vehicle Rental – Premium None Airfare – Premium Train – Premium Vehicle – Privately Owned Carrier Name       Flight Number       Departure Point       Departure Date              Departure Time   :   AM PM Arrival Point       Arrival Date              Arrival Time   :   AM PM Type of Travel Airfare – Coach Train – Coach Vehicle Rental – Premium None Airfare – Premium Train – Premium Vehicle – Privately Owned Carrier Name       Flight Number       Departure Point       Departure Date              Departure Time   :   AM PM Arrival Point       Arrival Date              Arrival Time   :   AM PM Type of Travel Airfare – Coach Train – Coach Vehicle Rental – Premium None Airfare – Premium Train – Premium Vehicle – Privately Owned Carrier Name       Flight Number       Departure Point       Departure Date              Departure Time   :   AM PM Arrival Point       Arrival Date              Arrival Time   :   AM PM Type of Travel Airfare – Coach Train – Coach Vehicle Rental – Premium None Airfare – Premium Train – Premium Vehicle – Privately Owned Carrier Name       Flight Number       Departure Point       Departure Date              Departure Time   :   AM PM Arrival Point       Arrival Date              Arrival Time   :   AM PM

Reviews and Approvals
1. Local Approver
Name	Approver Site	Result: Approved Disapproved Pass	Signature	Date (mm/dd/yyyy)             
Comments:
2. Local Approver
Name	Approver Site	Result: Approved Disapproved Pass	Signature	Date (mm/dd/yyyy)             
Comments:
3. Local Approver
Name	Approver Site	Result: Approved Disapproved Pass	Signature	Date (mm/dd/yyyy)             
Comments:
4. Head of Organization
Name	Approver Site	Result: Approved Disapproved Pass	Signature	Date (mm/dd/yyyy)             
Comments:
5. Programmatic RPSO
Name	Approver Site	Result: Approved Disapproved Pass	Signature	Date (mm/dd/yyyy)             
Comments:
6. Funding RPSO
Name	Approver Site	Result: Approved Disapproved Pass	Signature	Date (mm/dd/yyyy)             
Comments:

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