Main Page   Policy   Appendices A-1: ITA Telework Application and Agreement A-2: ITA Telework Safety Checklist A-3: ITA Telework Termination Form A-4: Telework Screening Guidelines A-5: Guidance for Identifying Jobs/Duties in ITA Suitable for Telework A-6: Federal Telecommuting Centers

International Trade Administration Telework Appendices TELEWORK TERMINATION FORM The telework option is not an employee right but rather falls under the supervisor’s discretion to determine how work should be accomplished with the organization. Termination from the telework agreement can be either voluntary or involuntary. This is notification that the telework agreement which was signed on __________________ is no longer in effect and is hereby terminated. Employee’s Name________________________________________________________________________ Organization_____________________________________________________________________________ Termination is based on (Please check one): Voluntary Withdrawal Involuntary Withdrawal If involuntarily terminated, this decision was based on: Requirements of the Current Work Assignment Reassignment or Change in Duties Lack of Office Coverage Failure to Maintain Eligibility Standards (Please specify): Other (Please Specify): ______________________________________________           _____________ Employee’s Signature                                                                       Date ______________________________________________            _____________ Supervisor’s Signature                                                                      Date ______________________________________________            ____________ Approving Official’s Signature                                                           Date