Rev 08/13
Louisiana State University
Office of Accounting Services
Payroll
204 Thomas Boyd Hall
REQUEST FOR CELLULAR TELEPHONE SERVICE AS542
This is a (check one):
Recertification of need for cellular telephone service
Request for approval of cellular telephone service
Approval (for either of above) is sought based on the criterion checked below:
Protection of Life and Property - my job duties require the performance of duties that could impact the
protection of life and property. These duties may be impeded without immediate access (inbound and/or
outbound) to the public telephone network, regardless of time of day or my location.
Law Enforcement - my daily job duties require the performance of law enforcement activities, and
these activities may expose me or the general public to harm or danger.
Personal Safety - my daily job duties require the performance of activities that may expose me or
others to harm or danger.
Public Welfare - my daily job duties require the performance of duties that may directly impact the
safety, health, and welfare of the general public.
Improved Efficiency & Effectiveness - my job duties require immediate access (inbound and/or
outbound) to the public telephone network for recall, consultation, and/or decision making. Lack of
instantaneous communications could have significant effect on the operational efficiency of the University
or significant impact on the economic or political welfare of the State.
On Call - my duties require me to be immediately accessible after normal work hours, regardless of
location.
Mobile or In Transit - my duties require me to be mobile or in transit a large percentage of the
business day yet immediately accessible.
Lack of Suitable Communications Alternatives - no other suitable communications alternatives (one-
way or interactive pagers, two-way radio, standard telephone service) are available due to the location or
environmental conditions of my workplace.
Requested by
___________________________________ ____________________________________ _________________
Signature Printed Name Date
Approved by
__________________________ __________________________ __________________________ __________
Dean/Director Printed Name Department Date
_____________________________________ _____________________
Chief Information Officer Date
Send approved forms to : 200 Computing Services
