Request for Temporary Cross-Border Remote Work Authorization

Employee Full Legal Name

Employee ID Number

Official Job Title

Department/Division

Direct Manager Name

Employment Classification

Current Work Location (City, State/Province, Country)

Destination Country for Remote Work

Full Destination Address (including postal code)

Total Number of Business Days Requested

Primary Work Arrangement at Destination

Detailed Business Justification for Cross-Border Remote Work

Nature of Work to be Performed While at Destination (select all that apply)

Will you be generating revenue or conducting billable client work from the destination location?

Primary Time Zone During Remote Work Period

Will you maintain consistent overlap with your primary team's core business hours (minimum 4 hours)?

Emergency Contact Name at Destination

Emergency Contact Phone Number (include country code)

Local Address for Official Correspondence (if different from work address)

Have you previously worked from this destination country/state within the current calendar year?

Total consecutive days expected at destination

Will your stay exceed 183 days within any 12-month period?

Does the destination jurisdiction have a double taxation treaty with your home country?

Will you have a fixed base, home office, or habitual place of work in the destination?

Will you be conducting activities that could be considered 'sales agent' or 'dependent agent' for the company in the destination?

Will you supervise or manage other employees or contractors located in the 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?

Types of company assets to be located at destination (select all that apply)

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?

Will you be performing services for clients located in the destination jurisdiction?

Risk Assessment: Permanent Establishment Exposure Level

Additional Tax Risk Factors or Mitigation Strategies

Data Classification Level of Work to be Performed

Types of Data Systems to be Accessed (select all that apply)

Will you use a company-approved VPN for all work-related network traffic?

Does the destination jurisdiction have data localization or data residency laws?

Will you transfer data across international borders (e.g., from destination to home country or third countries)?

Primary Computing Device for Work

Is full disk encryption enabled on all work devices?

Will you use public Wi-Fi networks for work activities?

Will you print or physically store company documents at the destination?

Will local IT support or third-party technicians have access to your devices?

Are there any export control restrictions on the data or technology you will access?

Backup and Recovery Plan in Case of Device Failure, Theft, or Compromise

Have you completed the mandatory Cross-Border Cybersecurity Training?

Do you require a visa or work permit to legally perform work in the destination jurisdiction?

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?

Will you be subject to local labor laws and employment regulations in the destination jurisdiction?

Have you obtained comprehensive travel medical insurance covering the entire duration?

Does your insurance cover emergency medical evacuation and repatriation?

Will you maintain primary health insurance coverage in your home country during this period?

Does the destination require mandatory registration with local authorities within a specific timeframe?

Are there mandatory social security or pension contributions required in the destination?

Will you be subject to local mandatory paid leave entitlements?

Are there restrictions on maximum working hours or mandatory rest periods under local law?

Have you reviewed and acknowledged local health and safety obligations for remote workers?

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?

Has the International Tax team reviewed and approved the tax and permanent establishment risk assessment?

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?

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?

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?

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?

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)