This section captures essential employee information and detailed destination metadata to establish the foundation for cross-border work authorization assessment.
Employee Full Legal Name
Employee ID Number
Official Job Title
Department/Division
Direct Manager Name
Employment Classification
Full-Time Permanent Employee
Part-Time Permanent Employee
Fixed-Term Contract Employee
Independent Contractor
Consultant
Current Work Location (City, State/Province, Country)
Destination Country for Remote Work
Destination State/Province/Region
Destination City
Full Destination Address (including postal code)
Proposed Start Date of Remote Work
Proposed End Date of Remote Work
Total Number of Business Days Requested
Primary Work Arrangement at Destination
Fully Remote (working from residence)
Hybrid (combination of remote and client/office site)
Client Site-Based (working primarily at client location)
Co-working Space
Other
Specify co-working space provider and address
Describe alternative work arrangement
Detailed Business Justification for Cross-Border Remote Work
Nature of Work to be Performed While at Destination (select all that apply)
Administrative/Internal Support
Client-Facing Services
Sales & Business Development
Technical/Engineering Work
Research & Development
Training & Knowledge Transfer
Project Management
No Active Work (personal leave/standby)
Will you be generating revenue or conducting billable client work from the destination location?
Specify clients, projects, and estimated revenue attributable to destination jurisdiction
Primary Time Zone During Remote Work Period
Will you maintain consistent overlap with your primary team's core business hours (minimum 4 hours)?
Explain plan for communication, collaboration, and meeting attendance despite limited overlap
Emergency Contact Name at Destination
Emergency Contact Phone Number (include country code)
Local Address for Official Correspondence (if different from work address)
This section assesses potential tax and permanent establishment risks that could create unintended corporate or personal tax obligations in the destination jurisdiction. Accurate completion is critical to prevent adverse tax consequences for both the employee and the organization.
Have you previously worked from this destination country/state within the current calendar year?
Cumulative days already spent working in this destination during current tax year
Total consecutive days expected at destination
Will your stay exceed 183 days within any 12-month period?
Basis for 183-day calculation
Calendar year
Rolling 12-month period
Tax year of destination country
Tax year of home country
Does the destination jurisdiction have a double taxation treaty with your home country?
Specify treaty name and key provisions relevant to employment income
WARNING: Absence of double taxation treaty may result in higher risk of double taxation. Additional review by International Tax team is strongly recommended.
Will you have a fixed base, home office, or habitual place of work in the destination?
Describe the nature and permanence of the workspace
Will you be conducting activities that could be considered 'sales agent' or 'dependent agent' for the company in the destination?
Describe agency activities and authority to conclude contracts on behalf of the company
Will you supervise or manage other employees or contractors located in the destination jurisdiction?
Number of direct reports in destination jurisdiction
Will you have signing authority for legal contracts, bank accounts, or corporate decisions in the destination?
Does the company already have a legal entity, branch office, or registered presence in the destination jurisdiction?
Specify entity type and registration number
Will this remote work arrangement create the company's first physical presence in this jurisdiction?
Types of company assets to be located at destination (select all that apply)
No company assets
Company-issued laptop
Company-issued mobile device
Company credit card
Company vehicle
Inventory or stock
Equipment or machinery
Server or IT infrastructure
Other tangible assets
Estimated value of company assets to be located at destination (in USD equivalent)
Will you be deriving income sourced from the destination jurisdiction's economy?
Estimated amount of destination-sourced income (USD equivalent)
Will you be performing services for clients located in the destination jurisdiction?
List client names and nature of services
Risk Assessment: Permanent Establishment Exposure Level
Low Risk (administrative work, no client interaction, <30 days)
Medium Risk (some client contact, 30-90 days, no authority)
High Risk (sales activities, >90 days, signing authority, revenue generation)
Critical Risk (agency relationship, >183 days, local hires, asset presence)
Additional Tax Risk Factors or Mitigation Strategies
This section ensures that data protection, cybersecurity, and IT infrastructure requirements are met to safeguard company and client information when working across borders. Non-compliance may result in data breaches, regulatory penalties, and reputational damage.
Data Classification Level of Work to be Performed
Public (non-sensitive information)
Internal (general business information)
Confidential (client data, proprietary information)
Restricted (financial data, PII, health records, trade secrets)
Will confidential data be stored on local devices or transmitted through local networks?
REQUIREMENT: Enhanced encryption and secure VPN mandatory. Local data residency laws must be reviewed.
Will restricted data be accessed from this location?
CRITICAL: Restricted data access from foreign jurisdictions requires CISO approval and may be prohibited. Additional security controls mandatory.
Types of Data Systems to be Accessed (select all that apply)
Email and calendar
Internal document repositories
Customer Relationship Management (CRM)
Financial systems
HR and payroll systems
Development environments
Production servers
Backup systems
Third-party cloud services
Will you use a company-approved VPN for all work-related network traffic?
MANDATORY REQUIREMENT: Company VPN must be used for all work activities. Request VPN access if not already provisioned.
Does the destination jurisdiction have data localization or data residency laws?
Describe applicable data localization requirements and compliance plan
Will you transfer data across international borders (e.g., from destination to home country or third countries)?
Describe data transfer mechanisms and legal basis (e.g., Standard Contractual Clauses, Binding Corporate Rules)
Primary Computing Device for Work
Company-issued laptop
Company-issued desktop
Personal computer (BYOD)
Combination of company and personal devices
Has your personal device been approved by IT Security and enrolled in Mobile Device Management (MDM)?
BYOD without MDM enrollment is not permitted for cross-border work. Contact IT Security immediately.
Have all devices been approved by IT Security and enrolled in Mobile Device Management (MDM)?
All devices must have MDM enrollment. Contact IT Security immediately.
Is full disk encryption enabled on all work devices?
MANDATORY: Full disk encryption must be enabled before departure. Contact IT Support.
Will you use public Wi-Fi networks for work activities?
WARNING: Public Wi-Fi poses significant security risks. VPN usage is mandatory. Avoid accessing sensitive systems on public networks.
Will you print or physically store company documents at the destination?
Describe physical security measures for document storage and disposal
Will local IT support or third-party technicians have access to your devices?
Describe circumstances and approval obtained from IT Security
Are there any export control restrictions on the data or technology you will access?
Specify export control classification and license requirements
Backup and Recovery Plan in Case of Device Failure, Theft, or Compromise
Have you completed the mandatory Cross-Border Cybersecurity Training?
TRAINING MANDATORY: Complete Cross-Border Cybersecurity Training before approval can be granted.
This section verifies compliance with immigration, insurance, and local employment law requirements. Failure to comply may result in personal liability, fines, deportation, or company sanctions.
Do you require a visa or work permit to legally perform work in the destination jurisdiction?
Visa/Permit Status
Already obtained
Applied and pending approval
Not yet applied
Visa-exempt (allowed to work under visitor status)
Uncertain - require legal assessment
Expected visa approval date
URGENT: Visa application must be submitted immediately. Approval timeline may impact start date.
REQUIRED: Immigration legal assessment must be completed before proceeding.
CONFIRMATION: You have confirmed that your nationality and purpose of stay permit work activities without a visa. Documentation may be required.
Visa/Permit Type and Category (if applicable)
Visa/Permit Validity Start Date (if applicable)
Visa/Permit Expiry Date (if applicable)
Does the destination jurisdiction restrict the type of work activities permitted under your visa/permit category?
Describe permitted and prohibited activities per visa conditions
Will you be subject to local labor laws and employment regulations in the destination jurisdiction?
Local Labor Law Compliance Requirements (select all that apply)
Registration with local labor authorities
Mandatory social security contributions
Local employment contract required
Working time directive compliance
Minimum wage requirements
Mandatory employee benefits
Health and safety training
Trade union notification
Workplace injury insurance
Have you obtained comprehensive travel medical insurance covering the entire duration?
MANDATORY: Travel medical insurance is required. Standard company-provided insurance may not cover international remote work.
Does your insurance cover emergency medical evacuation and repatriation?
RECOMMENDED: Emergency evacuation coverage is strongly advised for remote locations.
Will you maintain primary health insurance coverage in your home country during this period?
WARNING: Lapsing home country coverage may create gaps upon return. Verify portability options.
Does the destination require mandatory registration with local authorities within a specific timeframe?
Describe registration requirements and timeline
Are there mandatory social security or pension contributions required in the destination?
Describe contribution requirements and whether totalization agreement applies
Will you be subject to local mandatory paid leave entitlements?
Minimum local leave entitlement (in days)
Are there restrictions on maximum working hours or mandatory rest periods under local law?
Describe working hour restrictions and compliance plan
Have you reviewed and acknowledged local health and safety obligations for remote workers?
MANDATORY: Complete Local Health & Safety for Remote Workers training module.
Emergency Action Plan: Describe steps to take in case of political instability, natural disaster, medical emergency, or legal issues
Will you have access to legal counsel or immigration support in the destination jurisdiction if needed?
RECOMMENDED: Identify local legal support resources before departure.
This final section requires formal risk assessment, approval, and sign-off from designated authorities. All previous sections must be completed before submission for final clearance.
Risk Assessment Summary & Approval Matrix
Risk Category | Risk Level (1=Low, 5=Critical) | Mitigation Measures Implemented | Acceptable Risk? | ||
|---|---|---|---|---|---|
A | B | C | D | ||
1 | Tax Nexus & Permanent Establishment | Limited duration <60 days, no signing authority | Yes | ||
2 | Data Privacy & Security | VPN mandatory, encrypted device, no local storage | Yes | ||
3 | Immigration & Labor Law | Valid visa obtained, local counsel consulted | Yes | ||
4 | Health & Safety | Travel insurance, emergency plan documented | Yes | ||
5 | Business Continuity | Backup device, local IT support identified | Yes | ||
6 | |||||
7 | |||||
8 | |||||
9 | |||||
10 |
Has the International Tax team reviewed and approved the tax and permanent establishment risk assessment?
PENDING APPROVAL: Cannot proceed without International Tax clearance. Submit to tax@company.com.
International Tax Lead Reviewer Name
International Tax Approval Date
International Tax Lead Conditions or Restrictions (if any)
Has the Data Privacy Officer (DPO) or IT Security reviewed and approved the cybersecurity and data protection plan?
PENDING APPROVAL: Cannot proceed without IT Security clearance. Submit to security@company.com.
Data Privacy/Security Reviewer Name
Data Privacy/Security Approval Date
IT Security Conditions or Restrictions (if any)
Has the HR Business Partner reviewed and approved the labor law and immigration compliance aspects?
PENDING APPROVAL: Cannot proceed without HR Business Partner clearance.
HR Business Partner Reviewer Name
HR Business Partner Approval Date
HR Business Partner Conditions or Restrictions (if any)
Has the employee's direct manager approved the business justification and productivity plan?
PENDING APPROVAL: Cannot proceed without direct manager approval.
Direct Manager Name
Direct Manager Approval Date
Direct Manager Conditions or Restrictions (if any)
Final Approval: Does the HR Director authorize this cross-border remote work request?
REQUEST DENIED: Final approval not granted. Employee will be notified of denial reasons and potential alternatives.
HR Director Name
HR Director Final Approval Date
Overall Conditions, Restrictions, and Special Provisions
I acknowledge that this approval is temporary and does not establish a permanent right to work from the destination jurisdiction
I agree to immediately report any changes in circumstances (extended duration, change of address, change in work nature) to HR and International Tax
I understand that the company may revoke this approval at any time if compliance risks emerge or business conditions change
Next Review Date (if extension requested)
Employee Digital Signature - Acknowledgment of Terms
HR Director Digital Signature - Final Authorization
International Tax Lead Digital Signature - Tax Clearance
Documentation Checklist: All required documents have been attached (visa copy, insurance certificate, tax residency forms, IT security checklist)
To configure an element, select it on the form.