Employee Residency Audit Proposal Request

Requestor's Name:

Requestor's Title:

Requestor's Address:

City:

State:

Zip:

Phone:

Ext:

Email:

Agency/Department Name:

Total number of employees required to live within the permitted area?

Do you currently suspect any employees living outside the permitted area?
YesNo

If so, approximately how many?

Has there been a problem with employee residency requirements in the past?
YesNo

Have you ever audited your entire employee roster to confirm residency?
YesNo

Do you currently employ anyone to confirm employee residence?
YesNo

If Yes, full-time or part-time?
F/TP/T

On average, how many residency violators are identified per year?

Which departments do you have the most problems with?

Please leave this field empty.