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Telecommuting Agreement
Employee Name: ______________________________
Company Name: ______________________________
Employee ID #: ______________________________
Department: ______________________________
SSN: ______________________________
Supervisor Name: ______________________________
Start Date: _______________ End Date: _______________
Terms
Employee's Remote Work Location: ______________________________
Work Space Entails: ______________________________
Equipment Needed: ______________________________
Paid for By: ______________________________
Schedule
Telecommuting Days: Monday Tuesday Wednesday Thursday Friday
Telecommuting Hours: Start: _______________ End: _______________
Break Times: ______________________________
Total Amount of Time: ______________________________
In-Office Days: Monday Tuesday Wednesday Thursday Friday
In-Office Hours: Start: _______________ End: _______________
I have read and understand the telecommuting agreement policy for the aforementioned company. I agree to abide by the terms and conditions outlined in those documents. I understand that this contract may be terminated at any time.
Employee Signature: ______________________________
Date: ______________________________
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