Export Control International Travel/Telework Form

ONLY SUBMIT ONE FORM PER TRIP

US export control regulations govern the export of, and access to, items under its jurisdiction. "Items" refers to physical commodities, technology in any form, and software (including both source and object code). Therefore, when traveling abroad for LBNL business or with LBNL property, safeguarding items and sensitive data under your control must be a priority.

An export not only includes the shipment (or hand carrying) of a physical commodity from one country to another, but also the physical, visual, oral, and electronic release or transfer of an item to a foreign person, whether in the US or abroad. A "foreign person" is a person who is not a lawful permanent resident of the United States, citizen of the United States, or any other US-protected individual.

This form is to be completed by the traveler to record their trip with the Export Compliance Office (ECO). Click here for FAQs. Otherwise, you may contact us at exportcontrol@lbl.gov with any export compliance questions.

Do not submit this form unless you have obtained both supervisor and division director approval.

If you are unable to comply with the requirements and the guidelines outlined below, including working from or traveling to Belarus, Cuba, Iran, North Korea, Russia, Syria, or Ukraine, DO NOT submit this form. Instead, contact us directly at exportcontrol@lbl.gov.

Step 1: Training

Select whether you are traveling for Business or Personal reasons.*

If your trip involves both personal and business travel, please select "Business".

Business (paid for by LBNL)

Personal (paid for by you)

Are you attending a virtual conference (with no international travel)?

Complete the Export Control Module for Travel Abroad (ECO 0104). Save of copy of the email confirmation and upload it below.

Mark this checkbox to indicate you have completed ECO 0104 within the past 12 months.*

Complete the Export Control Module for International Collaboration (ECO 0106). Save a copy of the email confirmation and upload it below.

Mark this checkbox to indicate you have completed ECO 0106 within the past 12 months.*

Upload Proof of Completed Training Module*

Drag and drop files here or

Step 2: Traveler Information

Supervisor Name*

Supervisor Email*

Traveler Name*

Traveler Email*

LBNL Badge ID Number*

Please enter the six-digit LBNL ID number found on your badge or at phonebook.lbl.gov. Your UC ID number is not acceptable.

Division*

Select

Are you a US Person as defined below?*

US Citizen
US Lawful Permanent Resident (e.g., green card holder)
US Protected Person (e.g., asylee status holder)

Yes

What is your country of citizenship/nationality?*

Select

First Day of Travel*

For virtual conferences, enter the first conference date.

Last Day of Travel*

For virtual conferences, enter the last conference date.

Select all countries related to telework, business travel, and/or conference attendance:*

For virtual conferences, enter the country of the organizing institution.

Select

Export Restrictions Apply

STOP HERE and contact the ECO directly at exportcontrol@lbl.gov.

DO NOT SUBMIT FORM

Travel to or work from Belarus, Cuba, Iran, North Korea, Russia, Syria, and Ukraine is restricted and requires an additional review beyond the scope of this form.

Please describe in detail your intended scope of work (SOW) while traveling abroad:*

This SOW should be identical to what will be provided to other Lab approvals for this same trip.

If you are speaking at a conference, describe the research you will be presenting on.

Step 3: Review the Following

Prior to traveling, you are expected to read, understand, and comply with the following:

For additional guidance, visit the export control website.

I have read and understood the information provided by UC above.*

Step 4: By clicking "Submit," I agree to the following while traveling abroad:

1. My supervisor and division director are aware and supportive of this request.

2. I will not travel with export-controlled or proprietary information, data, or software source/object code saved locally on my electronic devices (including not making local copies of such items while abroad). I will only access these items remotely from Berkeley Lab cloud servers (e.g., Google Drive) using a Virtual Private Network.

3. I will not transfer or release export-controlled or proprietary information, data, or software source/object code to anyone while abroad.

4. I will ensure that the software installed on my electronic devices will be limited to mass market products or what is already publicly available.

5. The items in my possession do not require special protection for national security or foreign policy reasons.

6. I will contact the ECO prior to my trip if I will be traveling with any LBNL-owned physical commodities other than my LBNL-issued laptop and cellphone. Examples include:

Prototype devices or hardware components
Raw materials or scientific samples
Military instruments (i.e., any item identified as having a defense purpose, or built, designed, or modified to military specifications)

7. I will not collaborate with institutions or persons, domestic or foreign, that are sanctioned by the US government, or located in Belarus, Cuba, Iran, North Korea, Russia, Syria, or Ukraine.

8. I will not work from or travel through Belarus, Cuba, Iran, North Korea, Russia, Syria, or Ukraine.

If you are unable to comply with the requirements and the guidelines outlined above, DO NOT submit this form. Instead, contact us directly at exportcontrol@lbl.gov.

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