Esad Travel Request printable pdf download

APPENDIX 6:

ESAD TRAVEL REQUEST

MISSION START DATE: (First day on duty assigned to Mission/Incident on CaESADS PAR)

(Allow 4 hours to process your travel request)

Airline Request: Yes/No

Lodging Request: Yes/No

Rental Request: Yes/No

ESPB Travel Section will make appropriate travel arrangements for airline and hotel. Transportation to and from the airport, hotel and

work center is the responsibility of the Directorate/Unit until JOC determines that shuttle service may be required.

Full name as it appears on drivers license:

Driver license number and issue state:

Home address:

Email address:

Phone number for Service member:

Rank:

Last 4 SSN:

DOB mm/dd/yyyy:

Gender (required for airlines):

10. Full Time Status: (Please select one)

[ ] AGR [ ] ADOS [ ] ITO- (Needs Invitational Travel Orders to be on Emergency State Active Duty)

[ ] TECH – (Technician status not taking leave will continue to be paid by Technician branch)

[ ] TECH -LWOP Must submit a copy of Leave Form (OPM 71 or OTAG 900-14 must be included)

[ ] MDAY [ ] SMR [ ] CIV

11. Mission/Incident (Must be on a PAR to travel)

12. FRAGO:

13. Home Unit(not the Unit that is tracking them on ESAD):

14. Unit POC and phone number:

15. Airline to and from location:

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

MapQuest - Verify HOR is greater than 50 miles

Yes/No

Airline Travel From:_____________ To:_____________ Time: _______Flight #_________

Lodging Location:_______________ Check-in Date:___________ Check-out Date:________

Car Rental Location:____________ Pick up Date: _____________Return Date:__________

**You are required to process a CalATERS Global Travel claim within 72 hours of your travel.

**If you are driving your Privately Owned Vehicle (POV) you are required to fill out a POV form and have your

Commander’s approval/signature prior to you traveling. The POV form requires pre-approval for travel reimbursements

and expires yearly.

* PRIVACY STATEMENT

The Information Practices Act of 1977 (Civil Code Section 1798.17) and the Federal Privacy Act (Public Law 93 -579)

require that the following notice be provided when collecting personal information from individuals.

AGENCY NAME: Appointing powers and the State Control ler's Office (SCO).

UNITS RESPONSIBLE FOR MAINTENANCE: The accounting office within each appointing power and the Audits

Division, SCO, 3301 C Street, Room 404, Sacramento, CA 95816.

AUTHORITY: The reimbursement of travel expenses is governed by Governme nt Code Sections 19815.4(d), 19816, and

19820. These sections allow the Department of Personnel Administration (DPA) to establish rules and regulations which

define the amount, time, and place that expenses and allowances may be paid to representatives of the State while on State

business.

PURPOSE: The information you furnish will allow the above -named agencies to reimburse you for expenses you incur

while on official State business.

OTHER INFORMATION: While your social security account number (SSAN) and home address are voluntary information under

Civil Code Section 1798.17, the absence of this information may cause payment of your claim to be delayed or rejected. You should

contact your department's Accounting Office to determine the necessity for this information.

Esad Travel Request

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