GOVERNMENT TRAVEL CHARGE CARD PROGRAM
NEW EMPLOYEES (MILITARY AND CIVILIAN)
TRANSFERRING TO U. S. NAVAL ACADEMY
Privacy Act Statement –
Authority: 5 USC 5707 and implementing Federal Travel Regulation, 41 CFR 300-304; 5 USC 5738; EO
11609; 36 CFR 13747 (1971); 31 USC 1348; PL 107-56 SEC 326.
Principal Purpose(s): Used to establish a beginning-to-end travel services system containing information
to enable travel service providers to authorize, issue, and account for travel and travel reimbursements
provided to individuals on official Federal government business. SSN is used to maintain an identification
of an individual. This information is confidential and is needed so as not to confuse individuals with same
or similar names.
Routine Use(s): To provide travel documents for individuals on official Federal government business and
substantiate claims for reimbursement for official travel.
Disclosure: Voluntary, however, failure to furnish information requested may result in denial of official
travel orders.
NEW EMPLOYEE INFORMATION
NAME:
_________________________________________________
DEPARTMENT:
_________________________________________________
HOME ADDRESS: _________________________________________________
_________________________________________________
WORK PHONE:
_________________________________________________
HOME PHONE:
_________________________________________________
RANK/GRADE:
MILITARY ________________ CIVILIAN _____________
DATE OF BIRTH:
_______________
SOCIAL SECURITY NUMBER:
_____________________________________
GOVERNMENT TRAVEL CARD NUMBER: _____________________________
COMMAND TRANSFERRING FROM
NAME:
__________________________________________________
ADDRESS:
__________________________________________________
ACTIVITY UIC:
__________________________________________________
POINT OF CONTACT:_________________________________________________
STATEMENT OF UNDERSTANDING – ON-LINE CARDHOLDER'S TRAINING
A NEW SIGNED STATEMENT OF UNDERSTANDING IS REQUIRED AT EACH ACTIVITY
AN EMPLOYEE TRANSFERS TO AND ON-LINE CARDHOLDER'S TRAINING
CERTIFICATE.
https://www.navsup.navy.mil/portal/page?_pageid=499,296237,499_326958&_dad=p5st
ar&schema=P5STAR
PLEASE RETURN THIS FORM AND THE SIGNED STATEMENT OF UNDERSTANDING TO:
COMPTROLLER DEPARTMENT, STOP 20F, 2nd FLR, HALLIGAN HALLPOINT OF CONTACT IS
MARTHA WALTMAN AT EXT 31627 OR 31616
USNA NNB 4650/4(2-07)