REGULAR / RECURRING TELEWORK AGREEMENT
The following constitutes the terms & conditions of the telework agreement between employee & supervisor
Employee Name (Last, First, MI):
Pay Plan: Job Series: Level/Grade:
Employee’s Alternate Worksite (check one): Home office or work area Telecenter Other
Location of work area at alternate worksite:
Phone: Fax: E-mail:
Biweekly Pay Period Employee Telework Schedule: The employee named above is approved to work at the
alternative worksite on a regularly scheduled basis in accordance with the following schedule:
EMPLOYEE WORK DAILY
FROM TO FROM TO
1 Week Monday
2 Week Monday
Official Duty Station: The employee’s official duty station for locality pay adjustments & travel is as follows &
corresponds to that on the most recent SF Form 50, Notification of Personnel Action:
General Provisions for Telework: It is the responsibility of the employee to ensure that a proper work environment is maintained at
the alternate worksite while teleworking . All teleworkers must complete & sign a telework agreement. The employee must complete & sign
a safety checklist identifying the alternate worksite safe for an official worksite, to ensure that all the requirements to do official work are met
in an environment that allows all tasks to be performed safely. The employee agrees to permit access to the alternate worksite by the HQ US
Army Sustainment Command (ASC) representatives as required, during normal working hours, to repair or maintain Government equipment
& to ensure compliance with the terms of this telework agreement.
Employees who telework must be available to work at their traditional worksite if called upon to do so by their supervisor or if necessitated
by work requirements.
The employee is required to designate one area in the home as the official work or office area that is suitable for performance of official
Government business. The Government’s potential exposure to liability is restricted to this official work or office area for the purposes of
The employee acknowledges that telework is not a substitute for dependent care. A teleworker must make acceptable dependent care
provisions, enabling total attention to assigned work without distraction.
The Government is not responsible for any operating costs that are associated with the employee using his or her personal residence as an
alternate worksite, including home maintenance, insurance, or utilities.
ASC Form 690-5, Feb 10 Replaces ASC 690-5, Oct 09, which is obsolete.
Time & Attendance, Work Performance, & Overtime: Time spent in teleworking status at an alternative worksite must be
accounted for & reported in the same manner as if the employee reported for duty at the traditional worksite.
The employee is required to satisfactorily complete all assigned work, consistent with the approach adopted for all other employees in the
workgroup, & according to standards & objectives in the employee’s contribution/performance plan.
The employee agrees to work overtime only when ordered & approved by the supervisor in advance. Employees who work overtime
without such prior approval may be subject to administrative or disciplinary action.
Security & Equipment: No classified documents (hard copy or electronic) may be taken to the employee’s alternative worksite.
Sensitive unclassified material, including Privacy Act & For Official Use Only data, may be used with Government equipment. The
employee is responsible for the security of all official data, protection of any Government equipment & property, & carrying out the mission
of DA at the alternative worksite. Government equipment must only be used for official dates carried out by the employee. No other
persons are authorized to use the equipment. Only Government-issued equipment may be remotely connected to Government networks.
Employees may be authorized use of personally-owned computers, if accredited, to work on limited amounts of sensitive unclassified
material. Teleworker must delete all files as soon as they are no longer required & verify in writing that they have deleted all files
containing Government information from personally-owned computer hard drives. In addition, the employee must ensure that appropriate
antivirus software is installed on the computer & that all products of work while on duty under the telework agreement are returned to the
Government. Personally-owned computers are NOT authorized connection to Government computer networks.
Where the employee’s personally-owned computer is accredited for telework & the employee uses his/her personally-owned computer for
official purposes, the employee is responsible for the installation, repair, & maintenance of all personally-owned equipment.
AMSAS-IM is responsible for maintenance of all Government computer equipment. The employee may be required to bring the equipment
to the office for maintenance. All Government equipment & materials must be returned to the traditional worksite at the conclusion of the
teleworking arrangement or at the supervisor’s request.
Liability & Compensation: The Government is not liable for damages to the employee’s personal or real property while the employee
is working at the approved alternative worksite, except to the extent the Government is held liable by the Federal Torts Claim Act or the
Military & Civilian Employees Claims Act.
The employee is covered by the Federal Employees Compensation Act (FECA) when injured or suffering from work-related illnesses while
conducting official Government business. The employee is eligible to file a worker’s compensation claim for a work-related injury
sustained at an alternative work location under the FECA in accordance with current policies & procedures. The employee agrees to notify
the supervisor immediately of any accident or injury that occurs at the alternative worksite while performing official duties & to complete
any required forms.
Standards of Conduct: The employee acknowledges that he/she continues to be bound by the Department of Defense Standards of
Conduct while working at an alternative worksite.
Mileage Savings: The employee estimates that the regularly scheduled telework arrangement will result in a reduction of
approximately miles traveled in commuting per day.
Physician’s Statement (required only if request is based on physical illness or impairment): Physician’s statement describing
patient’s physical condition, potential duration, and the need/benefit for telework is attached Yes No
Termination of Telework Agreement: Either the employee or supervisor can terminate the scheduled telework agreement with
prior written notice. The supervisor shall terminate the telework should the employee not meet the prescribed standard, or should the
teleworking arrangement fail to meet organization needs.
Dates of Agreement: The regular/recurring telework arrangement covered by this agreement will begin on (date) & end on
Computer to be Used:
Government-Owned Only Is Government computer available for this employee? Yes No
ASC Form 690-5, Feb 10 (continuation)
I have read the telework requirements & procedures & understand the conditions for participating in the
program. I understand that failure to abide by the telework guidance may result in termination of this
Date Supervisor Telework Recommendation: Yes No
The employee named above is Approved / Disapproved to work at the identified alternate worksite on a
regular/recurring basis as identified above.
Date ASC Chief of Staff
ASC Form 690-5, Feb 10 (continuation)