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# DLA Official Forms

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| Form Number:  DLA1864                                                                                                                                                                                                                |
|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Form Title:  Telework Request and Approval Form                                                                                                                                                                                      |
| Form Version:  Oct 2022 (Modified                                                                                                                                                                                                    |
| Status:  Active                                                                                                                                                                                                                      |
| Functional Area:  Human Resources                                                                                                                                                                                                    |
| Opr:  J1                                                                                                                                                                                                                             |
| Safeguards:  PAS                                                                                                                                                                                                                     |
| Electronic:  Yes                                                                                                                                                                                                                     |
| Form Link:  Documents/FormsSite/forms/DL1864.pdf                                                                                                                                                                                     |
| Type:  Primary                                                                                                                                                                                                                       |
| Prescribed:  DLAI 7212                                                                                                                                                                                                               |
| Description:  This form authorizes employee participation in DLA's telework program.  Regarding duplicate use case, (ref, DLAI 7750.07, Paragraph 10b), DoD FMO authorizes DLA use of this form as a supplemental form DD Form 2946. |
| Records Retention:  5300.19 Telework/Alternate Worksite Program. Destroy 1 year after end of employee’s participation in the program, or after superseded form becomes obsolete.                                                     |
| Form Audience:                                                                                                                                                                                                                       |

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