Request for Approval of Ad Hoc Telework Arrangement Use to request telework on a one time basis 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name in the 'NAME OF EMPLOYEE' field. This identifies you as the requester.
  3. Fill in your 'TITLE/SERIES/GRADE' and 'ORGANIZATION' to provide context about your position and department.
  4. Identify the specific date(s) you wish to telework in the designated section. Be clear and precise.
  5. In the next field, briefly describe what you expect to accomplish while teleworking. This helps justify your request.
  6. Specify your telework location. If it's at home, detail the exact area where you'll conduct official business.
  7. Provide your contact information, including phone number, fax (if available), and email (if available).
  8. Sign the form in the 'SIGNATURE OF EMPLOYEE' section to validate your request.
  9. Ensure that supervisory approval is obtained by having your supervisor sign and date the form.

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