Remote Work Travel & Temporary Location Request Form

Employee Full Name

Employee ID Number

Job Title

Department

Official Work Email

Direct Manager Name

Request Type

Provide the original request reference number and explain why you need an extension:

Provide the original request reference number and detail the modifications required:

Provide the original request reference number and reason for cancellation:

Primary Purpose of Remote Work Travel (select all that apply)

Detailed Explanation of Work Objectives During Remote Travel

Emergency Contact Person Full Name

Emergency Contact Phone Number

Emergency Contact Relationship

Destination Country

Destination City/Region

Full Address of Primary Work Location

Proposed Start Date

Proposed End Date

Total Number of Working Days

Timezone of Destination Location

Will you maintain the same working hours as your primary work location?

Specify the overlapping hours between your destination timezone and your team's timezone:

Explain your planned work schedule and how you will ensure team collaboration and availability:

Is this destination considered a high-risk location due to political instability, high crime rates, health concerns, or natural disasters?

Describe the specific risks and the mitigation measures you will implement:

Will you be traveling with family members or dependents?

List all accompanying individuals and their relationship to you:

Primary Work Location Type

Name of co-working space:

Will you have access to a dedicated, ergonomic workspace (desk and chair)?

Explain how you will maintain ergonomic work conditions and prevent health issues:

Will you have access to reliable high-speed internet (minimum 20 Mbps download/5 Mbps upload)?

Describe your backup internet connectivity plans (e.g., mobile hotspot, secondary provider):

Will you be handling sensitive or confidential company data during this period?

I confirm I will use company-approved VPN at all times, encrypt devices, and never leave equipment unattended in public spaces.

Company Equipment You Will Take (select all that apply)

Do you require IT to ship equipment to your destination?

List specific equipment needed and the destination shipping address:

Will you be available for video calls during your team's core business hours (at least 4 hours overlap)?

Explain your alternative communication plan and how you will ensure effective collaboration:

How would you rate your technical self-sufficiency to troubleshoot connectivity or equipment issues independently?

Accommodation Booking Reference Number

Is your accommodation already booked and confirmed?

Explain your accommodation search plan and timeline for booking:

Will you have access to a kitchen for meal preparation?

Estimated monthly food budget:

Is the accommodation located in a safe neighborhood with easy access to emergency services?

Describe safety concerns and mitigation strategies:

Will you have access to reliable electricity and backup power if needed?

Describe backup power arrangements (e.g., UPS for equipment, generator availability):

Will you require a local mobile phone number or SIM card?

Estimated cost for local connectivity:

Do you have any pre-existing medical conditions that could require attention during your travel?

Describe the condition, required medication, and access to medical care at destination:

Are you currently taking any prescription medications that you must bring with you?

List medications and confirm you have sufficient supply for the entire duration plus 2-week buffer:

Have you researched required or recommended vaccinations for your destination?

Explain your plan to address vaccination requirements before travel:

Will you be covered by comprehensive travel and health insurance for the entire duration?

Explain your insurance coverage plan and provider details:

Are you aware of any current travel advisories or restrictions for your destination?

Describe the advisories and your mitigation plan:

Please assess the following risk factors for your destination (1 = Very Low Risk, 5 = Very High Risk)

Emergency Evacuation Plan: Describe your planned actions if you need to leave the destination urgently due to safety, health, or political reasons.

Have you verified that you can legally work in the destination country for the proposed duration without requiring a work visa?

Describe your visa/work permit status and application plan:

Do you understand that you are responsible for understanding and complying with local tax laws and regulations?

I acknowledge that I have researched local tax implications and will comply with all requirements. I understand the company is not responsible for personal tax liabilities.

Will you be accessing company systems or data that are subject to specific data residency or export control laws?

Describe the data types and confirm you have consulted with Legal/Compliance team:

I confirm that I have read and understood the company's Remote Work Policy and Travel Safety Guidelines.

I agree to maintain regular communication with my manager and team as per our agreed schedule.

I understand that the company reserves the right to revoke this approval at any time based on business needs, safety concerns, or policy violations.

I agree to provide a check-in notification upon arrival and weekly status updates during the remote work period.

Do you require any special accommodations under accessibility or disability policies?

Describe the required accommodations and how they will be provided at the destination:

Comprehensive Cost Breakdown (Complete all applicable categories)

Total Estimated Cost for Entire Duration

Total Cost Approval Level Required

Will you be requesting an advance payment for any expenses?

Advance Amount Requested:

Will this remote work arrangement result in cost savings for the company (e.g., reduced office space usage)?

Explain the cost savings and provide estimated amount:

Upload your detailed itinerary or project plan (PDF, DOC, or XLS format)

Upload travel insurance certificate or policy document

Upload accommodation booking confirmation or rental agreement

Upload any required visa or entry permit documentation

Upload manager's preliminary approval email (if already obtained)

Do you consent to the company sharing relevant portions of this request with internal stakeholders (IT, HR, Legal, Finance) for approval and support purposes?

I declare that all information provided in this form is accurate and complete to the best of my knowledge.

I understand that submitting this request does not guarantee approval and that final authorization is subject to business needs, safety assessments, and budget availability.

Employee Signature

Submission Date & Time