CELL PHONE ALLOWANCE REQUEST
Please complete the fields below to request or cancel a cell phone allowance in conjunction with
Webster University’s Wireless Policy. Send the completed form including original signatures
to: payroll@webster.edu
Name: ______________________________________________ CARS ID: __________________
Department: _________________________________________ Office phone #: ______________
Job title: _____________________________________________ Cell phone #: _______________
Hourly Employee ($13.85 per pay check)
Salary employee ($15.00 per pay check)
NEW REQUEST CANCEL REQUEST
Allowance start date:
Business Justification:
Employee Certification:
I have read Webster University’s Wireless policy and understand my responsibilities as outlined. I
understand that the allowance provided by the University for wireless service is taxable income
and is not part of my base salary. I understand that contract provisions of any wireless service
plan I enter into under this program are my personal responsibility. I also certify that the wireless
service will be used in the performance of my job responsibilities at Webster University, as defined
by my supervisor.
________________________________________________ __________________
Approvals:
________________________________________________ __________________
Department Head Signature:
_________________________________________________ __________________
Payroll Department Date:
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