FORM

Remote Work
Agreement
ABC Company

This SAMPLE agreement is of general interest and is not intended to apply to specific circumstances. Make sure
to consult legal counsel to customize this agreement prior to implementation.

Purpose and Scope

This document establishes the terms and conditions of the agreement between [insert employee name] and ABC Company to
conduct remote work. ABC Company reserves the right to deny or revoke remote work privileges at their own discretion.

Employee Information:
Name: __________________________________________________________
Job title: ________________________________________________________
Department: _____________________________________________________
Remote work start date: _________________ End date: __________________
Temporary work location: ___________________________________________
Employee schedule: _______________________________________________

Definitions
Remote work refers to an arrangement where the employee works from home or from another location away from the usual
workplace. Depending on the details of the arrangement, remote work constitutes either a portion of the employee’s work time
or all of it.

Responsibilities
Position requirements and responsibilities will not change due to remote work. Employees face the same expectations in
relation to professionalism, work output and customer service, regardless of where the work is being performed. The amount
of time an employee is expected to work in a given week will not change, although the exact scheduling of allotted hours will
be left up to the discretion of their direct supervisor(s). If an employee’s physical presence is required at ABC Company’s
primary work location, he or she may be expected to report once given adequate notice.
Additionally, the employee agrees to abide by the following general rules:
 Be transparent about your availability and keep your calendar and availability status up to date, indicating when you are
online or offline.
 Maintain strong communication by conducting regular check-ins with your manager and co-workers.
 Utilize your webcam and phone instead of email as often as possible.
 Request PTO when you intend to be away from your work.
 Set up a dedicated workspace that allows you the most focus as possible, and that is ergonomically sound and free of
hazards.
 Understand that remote work is not a substitute for dependent care. Prepare a child care strategy if needed. Don’t work
and parent at the same time.
 Be patient and understanding with co-workers who don’t have ideal at home working conditions.

Prepared by Wallace Welch & Willingham

This Remote Work Agreement is a sample only. It may not prevent all injuries from occurring. It does not address all potential compliance issues with federal, state or local standards. Nor is it
meant to be exhaustive or construed as legal advice. Consult your legal counsel to address possible compliance requirements. © 2020 Zywave, Inc. All rights reserved.
Contact With Primary Location
The employee agrees to maintain regular contact with their supervisor(s). The supervisor(s) will act as the employee’s primary
contact at ABC Company. Both the employee and his or her supervisor(s) are expected to work together to keep each other
informed of any developments that occur during the workday.
The employee must receive approval from their supervisor(s) to:
 Alter their defined work schedules.

 Move company equipment to a new location.

 Transfer primary off-site operations to a new location.

Equipment
The employee agrees that, on a case-by-case basis, ABC Company may determine, with information supplied by the
employee and the supervisor, the appropriate equipment needs (including hardware, software, modems, phone and data lines,
and other office equipment) for each remote work arrangement. The human resource and IT departments will serve as
resources in this matter. Equipment supplied by the organization will be maintained by the organization. Equipment supplied
by the employee, if deemed appropriate by the organization, will be maintained by the employee.
Additionally, the employee agrees to abide by the following general rules:
 All equipment purchased by ABC Company remains the property of ABC Company.

 Hardware is only to be modified or serviced by parties approved by ABC Company.

 The employee must report to ABC Company any damage or modification to company-provided equipment as soon as
possible.

 Software provided by ABC Company is to be used only for its intended purpose and should not be duplicated without
consent.

 Any equipment provided by ABC Company for off-site use is intended for legitimate business use only.

 All hardware and software should be secured against unauthorized access.

 All equipment—including laptop and corresponding portable power supply, and voice devices such as a headset—is
to be returned in a timely fashion should the employee cease remote work operations for any reason.

SIGNATURES

I have read, understand and agree to comply with all provisions of the Remote Work Agreement. I understand that
any violation of the terms of this agreement may result in disciplinary action up to and including termination. My
signature serves as proof that I agree to the terms and conditions of this agreement.

EMPLOYEE NAME: SIGNATURE: DATE:

MANAGER NAME: SIGNATURE: DATE: