Out of State Work Location Request Form

This form is used for candidates who are being submitted for approval to work outside of the state of Georgia. Justification of request should include specific reasons that the employment is essential and critical to the teaching and research mission and how it cannot be met by a USG institution employee or a state of Georgia resident.

Requirements:

-Approvals from UHR and Payroll must be obtained prior to offers or agreements being made.

-This form must be submitted 8 weeks in advance of an offer to ensure the applicable state and country requirements are met.

If the request is approved:

Units are financially responsible for the costs of legal and tax compliance, and for any recurring administrative costs and penalties incurred by the institution for each out of state employee within their unit.

Units are responsible for submitting a Telework/Flextime Agreement.

Please visit the Out of State Website for important information and steps: https://hr.uga.edu/Information_Directory/out_of_state_employment/

Requesting Unit's Information

Requestor's Name

Requestor's Email

Requesting Unit

Requesting HR Department

Information on the Candidate

Is the candidate a current employee?

Yes

EMPLID

If not a current employee, leave blank.

Employee's Full Name

Employee's Position Number

If not a current employee, indicate the position the employee is being considered for.

Employee's Job Title

If not a current employee, indicate the position title the employee is being considered for.

Employee Type

Employee's Pay Group

If not a current employee, indicate the pay group the employee would be in if hired.

Salary Information

If not a current employee, indicate the salary or the approximate salary that the candidate would be offered if approved. Please note that this is not an approval process for salary requests, but this information assists Central Offices to determine financial estimates with vendors.

Is this request intended 6 months or less?

Yes

Agreements will need to be reviewed to determine costs, impact and sustainability for AWA and any Out of State employment, where applicable.

Start Date

Indicate the desired start date should the employee/candidate be approved to proceed

mm/dd/yyyy

Estimated End Date

Please include an end date for this arrangement.

Location Information

Please add State, Country and Zip code that the candidate will be located should the request be approved. If a current employee, please share where the employee is requesting to work:

Country of Residence

Physical Work Location

Additional Details

What primary job duties will the employee be performing in this remote position? Please provide a description of your job expectations for this position and/or attach a copy of the job description below.

Please specify the systems, software, databases, or other platforms (whether provided by UGA or external) that this employee will access as part of their role. Additionally, indicate whether the employee will be in possession of any UGA-owned property, such as a mobile phone, laptop, or other equipment. Be as specific and detailed as possible.

Provide justification or reason for this employee to work outside of Georgia, including why this position cannot be filled with an employee working in the state of Georgia.

File Upload

Drop your files here

Review Process

The out-of-state work location request form must be routed and signed by the candidate/employee’s immediate supervisor, HR Liaison, and the Vice President or Designee.

Requests will be reviewed on a first come, first served basis by a committee including representatives from UHR and Payroll. All committee reviewers must approve the out-of-state location before an offer of employment or work arrangement is approved

I understand these steps and I am submitting this information on behalf of my unit. This will include the acknowledgement of the financial obligations that will be charged to my unit for this offer of employment. I am aware that all requests require an 8 week period to offers for approvals and those with new state requests may take additional time for processing.

Send me a copy of my responses

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