This section collects your personal details and remote work setup information to establish a secure and compliant remote working arrangement. All fields marked as mandatory must be completed to process your agreement.
Employee ID Number
Full Name
Department
Job Title
Primary Remote Work Location Address
Contact Phone Number
Work Email Address
Emergency Contact Name and Phone
Emergency Contact Phone
Expected Percentage of Work Conducted Remotely (0-100%)
Remote Work Agreement Start Date
IT Equipment Assignment and Verification
Acknowledge Receipt | Asset Tag Number | Equipment Type | Manufacturer | Model Number | Serial Number | Replacement Value | Condition at Issue | |
|---|---|---|---|---|---|---|---|---|
Are you receiving any additional equipment not listed above?
By acknowledging below, you accept full responsibility for the security, maintenance, and proper use of all assigned equipment. This includes protection against theft, damage, and unauthorized access.
I acknowledge that I have physically received and inspected all equipment listed in Section 2 and confirm it is in proper working condition.
I understand that I am personally responsible for the security of all company equipment in my possession at all times.
I agree to immediately report any loss, theft, or damage to IT equipment to the IT Security team.
Do you have personal insurance that covers company equipment in your home?
I agree to return all company equipment within 5 business days upon termination of employment or upon request by the company.
Your role may require access to sensitive company information. This section defines your data access level and associated handling responsibilities based on the classification scheme.
What is the highest classification level of data you will access remotely?
Public Information
Internal Use Only
Confidential Business Information
Restricted Sensitive Data
Select all data handling activities you perform as part of your remote work duties:
Data Processing
Data Storage (Local)
Data Storage (Cloud)
Data Transmission
Data Analysis
Data Sharing with Colleagues
Data Sharing with External Parties
Do you handle personal data of customers, clients, or employees?
Do you have access to financial or payment-related data?
Strong authentication is critical for securing remote access. This section verifies your understanding and implementation of access control requirements.
I use unique, complex authentication codes for each work-related account and system.
I have enabled Multi-Factor authentication (MFA) on all work accounts that support it.
How frequently do you update your work account authentication credentials?
Every 30 days
Every 60 days
Every 90 days
Only when required by system
Never
I always lock my computer screen when stepping away from my workspace, even for brief periods.
Do you use a authentication manager to store work-related credentials?
The physical security of your remote workspace is essential to protect company assets and information. Please assess and document your workspace security measures.
Is your primary work area located in a separate, lockable room with restricted access?
Can unauthorized persons (including family members) access your work computer or view your screen during work hours?
Do you have a secure, lockable storage solution for physical documents or removable media?
Who shares your remote work location? Select all that apply:
Spouse/Partner
Children
Roommates
Other Family Members
Visitors/Guests
No one - I live alone
Do you have a means to secure your laptop when not in use (e.g., cable lock, safe)?
Secure network connectivity is fundamental to protecting company data. This section assesses the security posture of your internet connection and network configuration.
What type of internet connection do you primarily use for remote work?
Home Broadband (Cable/Fiber)
Mobile Hotspot
Public Wi-Fi
Co-working Space Network
Satellite Internet
I use the company-provided VPN for all work-related activities, including email and file access.
Is your home Wi-Fi network secured with WPA3 or WPA2 encryption?
Have you changed the default administrator authentication on your home router?
Do you use personal devices (smartphones, tablets) to access company resources?
Unauthorized software can introduce security vulnerabilities. This section ensures you understand and adhere to the company's software installation policies.
I only install software applications that have been explicitly approved by the IT department.
Software Inventory and Approval Status
Software/Application Name | Version | License Type | IT Approved? | Business Purpose | Installation Date | |
|---|---|---|---|---|---|---|
Do you use cloud storage services (personal or corporate) to store or backup work-related files?
Which of the following security measures do you implement on applications containing work data? Select all that apply:
Application-level authentication protection
Two-factor authentication enabled
Automatic logout after inactivity
Encrypted data storage
Regular data backup to approved locations
Security awareness is an ongoing requirement. This section verifies your training status and assesses your understanding of key security concepts.
I have completed the mandatory Security Awareness Training within the last 12 months.
Rate your confidence in identifying phishing emails and social engineering attempts (1 = Not confident, 5 = Very confident)
I know the correct procedure to report a suspected security incident or data breach.
Which of the following security threats are you prepared to recognize and respond to? Select all that apply:
Phishing emails
Spear-phishing attacks
Malware infections
Ransomware attempts
Social engineering phone calls
Physical tailgating attempts
Insider threat indicators
Briefly describe the steps you would take if you suspect your work account has been compromised:
Transparency about past incidents helps improve security measures. This section documents any previous security events and confirms your understanding of reporting obligations.
Have you experienced any security incidents in the past 12 months while working remotely?
If you experienced an incident, was it reported to IT Security within 1 hour of discovery?
I understand that I must report any suspected security incident immediately to IT Security (within 1 hour of discovery), even if I am uncertain about the severity.
Primary IT Security Contact Email / Phone
This final section confirms your understanding and agreement to comply with all security policies and legal obligations. Your signature makes this agreement legally binding.
I have read, understood, and agree to comply with the Remote Work Security Policy and all related IT Security Policies.
I understand my obligations under applicable data protection regulations and commit to handling all data accordingly.
I acknowledge that non-compliance with these security requirements may result in disciplinary action, up to and including termination of employment.
I consent to periodic remote security audits and compliance checks of my work environment, with reasonable prior notice.
I understand that all work performed and data accessed using company equipment remains the property of the company, including intellectual property rights.
Are there any conflicts of interest or personal circumstances that might affect your ability to comply with these security requirements?
Additional comments or special considerations regarding your remote work security setup:
By signing below, you acknowledge that all information provided is accurate and complete, and you agree to abide by all terms and conditions outlined in this Remote Work IT Equipment & Data Security Compliance Agreement. This signature is legally binding.
Employee Signature
Signature Date and Time
Manager Approval Digital Signature
Manager Approval Date and Time