This section collects essential employee and destination information to assess the baseline context for international remote work authorization. Accurate completion is critical for downstream compliance analysis.
Employee ID
Full Legal Name
Current Department
Job Title
Direct Manager Name
Current Work Location (City, Country)
Employment Type
Full-time Employee
Part-time Employee
Contractor
Consultant
Original Hire Date
Destination Country
Destination City
Proposed Remote Work Start Date
Proposed Remote Work End Date
Total Duration in Days
Accommodation Type
Hotel
Short-term Rental
Co-living Space
Family or Friend Residence
Company-Provided Housing
Other
Accommodation Address
Primary Business Justification
Will you be performing client-facing work while abroad?
Provide client name(s), location(s), and nature of services to be performed
Will you be generating revenue from local sources in the destination country?
Describe revenue generation activities and estimated amounts in local currency
Previous international remote work days in current tax year
List all countries where you've worked remotely in the past 2 years
This section assesses whether your activities could create a taxable presence (Permanent Establishment) for the company in the destination country, triggering corporate tax filing and payment obligations.
Detailed description of work activities to be performed
Will you have authority to conclude contracts binding the company?
Describe the extent of your contract-signing authority and typical transaction values
Will you be negotiating terms with customers or suppliers located in the destination country?
Describe negotiation activities, frequency, and parties involved
Estimated percentage of time dedicated to revenue-generating activities
Will you supervise or manage employees based in the destination country?
Number of local employees supervised
Will you have a dedicated office space exclusively for company use?
Office address, lease terms, and whether company or personally leased
Will you regularly use a co-working space for company business?
Co-working space name
Does the company have any existing operations or subsidiaries in the destination country?
Describe existing operations and relationship to your proposed work
Is there a bilateral tax treaty between your home country and destination?
Tax treaty name/reference
PE Risk Factors Assessment Matrix
Risk Factor | Applicable | Description | Risk Level (1-5) | ||
|---|---|---|---|---|---|
A | B | C | D | ||
1 | Fixed Place of Business | ||||
2 | Dependent Agent Authority | ||||
3 | Construction/Installation PE | ||||
4 | Service PE Threshold | ||||
5 | |||||
6 | |||||
7 | |||||
8 | |||||
9 | |||||
10 |
Self-assessment of Permanent Establishment risk level
High Risk - Activities likely create PE
Medium Risk - Some PE indicators present
Low Risk - Activities unlikely to create PE
Uncertain - Requires tax counsel analysis
Proposed risk mitigation measures
This section evaluates your personal tax compliance obligations, payroll withholding requirements, and social security coverage implications in both home and destination countries.
Current Tax Residency Status
Upload tax residency certificate if available
Do you maintain a permanent home in your current tax jurisdiction?
Days spent in destination country in prior tax year
Projected days in destination country for current tax year
Components of compensation to be earned during remote period
Base Salary
Performance Bonus
Equity Compensation
Commission
Housing Allowance
Cost of Living Adjustment
Relocation Benefits
Other
Will you maintain social security coverage in your home country?
Explain alternative social security coverage plan and contribution strategy
Is there a totalization agreement between the countries?
Agreement reference number or treaty article
Does the destination country require local payroll registration?
Describe proposed payroll solution, shadow payroll, or withholding approach
Will you require tax gross-up for additional tax liabilities?
Justification for gross-up request and estimated cost
Are you subject to company tax equalization or tax protection policy?
Policy name or reference number
Do you have foreign asset or bank account reporting obligations?
Describe reporting requirements, thresholds, and compliance status
Additional tax considerations or special circumstances
This section reviews data protection, export control, and IT security requirements to ensure compliant remote work operations and mitigate data breach or regulatory violation risks.
Categories of company data you will access remotely
Customer Personal Data
Employee Personal Data
Financial Information
Intellectual Property
Technical Data
Export-Controlled Information
Health/Sensitive Personal Data
General Business Data Only
Provide ECCN numbers, control categories, and describe export control jurisdiction
Will you transfer personal data across international borders?
Primary data transfer mechanism
Standard Contractual Clauses (SCCs)
Binding Corporate Rules (BCRs)
Adequacy Decision
Derogations
Other Legal Basis
Will you use personal devices for company work?
List device types, ownership, and security measures implemented
Company device security compliance checklist
Full Disk Encryption Enabled
Mandatory VPN Connection
Multi-Factor Authentication
Anti-Malware Software
Remote Wipe Capability
Password Manager Usage
Screen Lock Enabled
Local internet infrastructure reliability assessment
Backup connectivity and business continuity plan
Are you aware of local surveillance or data localization laws?
Describe potential implications for company data and employee privacy
Local IT incident response contact
Software tools with known geo-restrictions or licensing limitations
Data breach notification and incident response plan
This final section summarizes risk assessments and captures required approvals for the temporary international remote work arrangement. All signatures must be obtained before commencement.
Overall Permanent Establishment Risk Rating
Overall Personal Income Tax Risk Rating
Overall Data Privacy & Security Risk Rating
Required approvals checklist
HR Mobility Lead
Corporate Tax Counsel
Legal Department
Information Security
Compliance Officer
Business Unit Head
No Additional Approvals Required
Special conditions, restrictions, or monitoring requirements
I have read and acknowledge the company's International Remote Work Policy
I understand that I remain personally responsible for individual tax compliance in all jurisdictions
I agree to comply with all data security, monitoring, and IT requirements outlined above
Local Emergency Contact Name
Local Emergency Contact Phone
HR Mobility Lead Name
HR Mobility Lead Approval
Corporate Tax Counsel Name
Corporate Tax Counsel Approval
Final Approval Date
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