Information Technology Policy Manual FY23-24

Cell Phone/Phone Stipend Request Form

Name: Lawson No: Position: Acct Number: Justification:

Department:

Requested: •

City-issued Cell Phone

• Cancel City Number _____________________________ • Personal Number for Stipend ______________________ • Stop stipend payment • Cell Phone Stipend • Phone and Data ($45.00 per month) • Phone Only ($25.00 per month)

**Before the Stipend can be approved or submitted to payroll you must return all ancillary equipment (EX: cables, chargers, case) to the Information Technology (IT) department Telecomm Services division only! **

I certify that I have received a copy of and understand the City of Greensboro Cell Phone Policy.

___________________________________________________________ Employee Signature Date

___________________________________________________________ Department Head Signature Date

DO NOT SUBMIT THIS FORM TO PAYROLL OR FINANCE. THE TELECOMMUNICATIONS DIVISION OF THE IT DEPARTMENT WILL FORWARD THIS REQUEST WHEN NECESSARY.

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