Unofficial Foreign Travel Reporting Form

Please review Section 1, complete Section 2, and then return the form to the security office. Be aware of additional reporting requirements for items in Section 3 upon return. Reporting information on this form complies with the requirements set forth in SEAD-3 and ISL 2021-02 and are required for all cleared personnel engaging in unofficial foreign travel.

Please note that travel to U.S. possessions or territories is not considered foreign travel and does not need to be reported (e.g., Puerto Rico, US Virgin Islands, etc.).

Section 1: Please review and be aware of the following information.

Review the NCSC “Safe Travels” resource at: Counterintelligence Tips Safe Travels

Review the Department of State Travel Advisories to determine if any of your travel (including layovers or transfers) will be in a country with an existing advisory. Be cognizant of any such advisories prior to travel and contact the security office if you have any questions.

Review the list of risk countries below. If you are travelling to one of the Primary Risk Countries, you may receive an additional security briefing prior to travel. If you are traveling to one of the Countries of Concern, it is highly recommended that you take additional time to review potential risks which may be encountered during your travel.

Primary Risk Countries

The following countries have been identified in the DNI Worldwide Threat Assessment of the U.S. Intelligence Community as being high risk. Cleared personnel traveling to these locations may require a pre-travel briefing conducted by a Counterintelligence Special Agent from the Defense Counterintelligence and Security Agency. Even if you do not receive a briefing, it is recommended that travelers to these areas maintain a high level of caution.

China

Iran

North Korea

Russia

Countries of Concern

The following countries may not require a briefing but were identified as places of concern in the Worldwide Threat Assessment. Travelers should take additional caution when traveling to these areas.

Afghanistan	Angola	Armenia	Australia
Azerbaijan	Belgium	Burkina Faso	Burma
Colombia	Cuba	Congo (DRC)	El Salvador
Ethiopia	France	Germany	Guatemala
Haiti	Honduras	Iceland	India
Iraq	Kenya	Mali	Mexico
Nicaragua	Poland	Rwanda	Somalia
South Africa	Syria	Tunisia	Ukraine
Venezuela	Yemen

Section 2: Please complete all fields below and return the form to the Security Office. This information is required under SEAD-3 and will be recorded in the System of Record (DISS).

Your Full Name *

Your Email *

Depart the USA: *

Dates of Travel

Arrival back in USA: *

Dates of Travel

Travel Document *

Passport Book

Passport Card

No Passport Used

(Select One. Add document info, if applicable)

Foreign Countries Visited *

Please list each country you will visit. Include the individual entry/exit dates and travel method to reach the country. Please use the Continuation/Special Notes Section 3 if you have additional countries to report or any unique information that you wish to provide regarding your travel.
Include: Country Name | Date of Entry | Date of Exit | Transportation Used (Air, Auto, Sea,Train, Walk)

Foreign Travel Associates

If applicable, please list the name and association (e.g., business, friend, relative, etc.) of any foreign national traveling companions.

Planned Foreign Contacts

If applicable, please list planned contacts with foreign governments, foreign companies, or foreign persons and the reason for contact (e.g., business, friend, relative, etc.)

Full Name of Emergency Contact *

First, MI, Last Name

Address of Emergency Contact *

Phone Number for Emergency Contact *

Relationship to Emergency Contact *

Submit

Section 3: Continuation/Special Notes

Please add any additional information that may be pertinent to your travel or if you need additional room for information relating to Section 2. Changes to your itinerary after initial submission should be entered here as well.

Upon the completion of your travel, please update this section to add additional notes if any of the following situations occur:

Unplanned contact with foreign governments, companies, or citizens during travel and reason for contact.

Unusual or suspicious occurrences, including those of possible security or counterintelligence significance.

Any foreign legal or customs incidents encountered.