UNITED STATES DISTRICT COURT
DISTRICT OF WYOMING
PROBATION OFFICE
http://www.wyp.uscourts.gov
Tambra J. Loyd
Chief U.S. Probation Officer
Paul E. Ricketts
Deputy Chief U.S. Probation Officer
Cheyenne
2120 Capitol Avenue, Suite 7008
P.O. Box 847
Cheyenne, WY 82003
(307) 433-2300
Fax: (307) 433-2305
Casper
111 South Wolcott, Room 300
Casper, WY 82601
(307) 232-2670
Fax: (307) 232-2680
Lander
125 Sunflower
P.O. Box 369
Lander, WY 82520
(307) 332-4891
Fax: (307) 332-4929
TRAVEL REQUEST (Revised 08/31/12)
Note: This form must be typed or neatly printed and received in the Probation Office at least one week prior
to departure date.
Name and Address:
Departure Date:
Return Date:
Home Phone: Work Phone: Cell Phone: Msg Phone:
TRAVEL INFORMATION
Purpose of Travel: Destination:
With whom will you be traveling:
Relationship:
ACCOMMODATIONS
Address where you will be staying upon arrival:
With whom:
Relationship:
Phone:
Largest City Closest to Destination: County of Destination:
MODE OF TRANSPORTATION
9 VEHICLE: Make, Model and Color: License Plate No. and
State:
Owner:
9 AIRLINE: Name of Airline: Departure Flight Number/Time:
Return Flight Number/Time:
9 OTHER MODE OF TRANSPORTATION (specify):
Signature: Date:
U.S. PROBATION OFFICER APPROVAL/DISAPPROVAL
9 Approve 9 Disapprove
U.S. Probation Officer Signature: Date:
