Form 126 – Fill Out and Use This PDF

Check the appropriate box at the top of the form for this submission: Change of information previously given, First time form completed or Separation / Retirement.

If residence, dependency or relationship status information is different from what was previously submitted, mark the appropriate box for the change made.

This form must be resubmitted prior to the retirement separation; check the box marked "Separation/Retirement" at the top of the form.

In 1.(a), check one Agency: State, AID, Commerce or Agriculture.

Enter the Duty Station/Bureau in 1.(b) and the Date of Birth (mm-dd-yyyy) in 2.

Enter the Name (Last, First, MI.) in 3.(a), the Social Security Number in 3.(b) and the Class (Grade) in 3.(c).

Enter the Current Location (City, State) in 3.(d). In item 4, enter the CITY and STATE you claim as your legal residence.

In 5.(a), enter the Address Used for Home Leave Purposes (Present Residence Number, Street, City, State and ZIP). In 5.(b), enter the Requested New Home Leave Address (Residence Number and Street, City, State and ZIP Code).

Item 6, the Reason For New Home Leave Address Change In 5 (b) Above, must be based on a close family tie or other compelling interests and not simply on a desire to visit the location or for personal convenience.

Valid justifications for changes of home leave address include death, relocation of a relative whose address was previously claimed, better climate needed for recorded health problem, sale or purchase of residential or business property, or change of legal residence.

Home leave residence may not be changed after travel orders have been issued without the prior approval of an appropriate authorizing officer in Washington, D.C.

In item 8, Service Separation Residence (Complete Address), enter the residence in the United States to which you would want to travel and utilize for authorized shipment of effects when you separate from service.

Provide house/apartment number, street, city, state/zip code for both the home leave residence and the separation residence.

No location/address change can be made after the effective date of the separation or once travel has commenced.

Check only the status code that describes your relationship status to a Foreign Service or Civil Service employee.

In 9 (a), Relationship Status: "S" Single, "M" Married or "DP" Domestic Partner.

If spouse or DP is a government employee, check the appropriate item in (b) or (c).

In 9 (b), check one for a spouse or DP who is a Foreign Service career or career candidate employee of: "C" State, "A" AID, "R" Commerce or "G" Agriculture.

In 9 (c), check "F" Your Agency, "L" Other Federal Government or Active Military for a spouse or DP who is a Civil Service employee or has military status.

In 10, enter the Name of Spouse or DP (Include Maiden Name), Social Security Number, Present Citizenship and Previous Citizenship.

11. Will spouse or DP travel as your dependent and reside with you abroad? Check Yes or No.

In 12 (a), Change of relationship status, check Marriage, Divorce, Death of Spouse or DP, DP Affadavit or DP Dissolution.

Item 12 (c) "Place" shows place of marriage or execution of domestic partner affidavit.

In 13 (a), name all qualifying dependent family members other than your spouse or DP who will normally travel at government expense and reside with you abroad.

For each dependent, enter the Name of Dependent, Relationship, Citizenship and Date of Birth (mm-dd-yyyy).

A dependent may be a spouse or domestic partner, children under age 21, or a relative who is at least 51% dependent on you for support (subject to review and approval of supporting documentation by the approving official as noted in Item 13 (a); an update is required with each new assignment abroad).

Attach documentation such as a monthly summary of income and expenses from ALL sources as evidence of support to substantiate a claim for any relative other than a dependent spouse, domestic partner, or children under age 21.

Children of divorced employees, spouses, or domestic partners cannot be listed on travel orders unless (a) a copy of the divorce decree establishing that the employee has physical custody of the children is on file in the appropriate personnel office (in joint custody cases, a notarized statement from the ex-spouse or ex-domestic partner authorizing the children to reside abroad is also required); and (b) children meet the dependency criteria contained in 14 FAM 511.3 Definitions "Eligible Family Members" (1) to (4).

You must attach a written justification to claim a dependent who does not meet standard dependency criteria (please refer to instructions).

You may attach a blank continuation sheet if necessary.

Travel will not be authorized for dependents unless a current OF-126 form has been approved listing the names of the dependents before the travel order has been produced.

In 13 (b), Change of Dependents, enter the (Name), Relationship, Date of Birth (mm-dd-yyyy), Citizenship, Gain/Loss, Place, Date of Gain (mm-dd-yyyy) and Reason.

For each event denoted in Item 12 (a) "Change of Relationship Status," Item 13 (b) "Change of Dependents" must be completed.

15. Person to Notify in Case of an Emergency: Name, Address, Telephone Number.

Date (mm-dd-yyyy) for 17, Employee Signature.

Item 16 is the Signature of Personnel Officer at Post. Post personnel officer's signature only indicates that the form and required documentation appear to be complete.

Any willful and material misrepresentation made on this form may result in a fine of not more than $10,000 or imprisonment of not more than five years or both (18 USC 1001) (checked October 31, 2026).

Distribution: State: HR/EX; AID: See Supplement 1B to HB32, Chapter 1; VOA P/F - Foreign Personnel Advisor; Commerce: Office of Foreign Service Human Resources; Agriculture: FAS/Personnel, APHIS/Human Resources Division; or appropriate agency Personnel Office. Copies: Original to personnel office; Copy retained by post Admin Section.