Employee Checklist Template - Free Download | Page 6
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SAMPLE TELECOMMUTING WORK AGREEMENT
Employee’s Initials: _________ 4
State-owned or leased equipment has been issued to the employee and has been documented by
the agency.
Issued Date Documented Date
computer
modem
fax machine
telephone
desk
chair
file cabinet
other
Supervisor Date
Employee Date
Agency Head (or designee) Date
source: resources.dhrm.virginia.gov
