Fillable WirelessCommunicationStipendRequest/Authorization (Southwest Virginia Community College)

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WirelessCommunicationStipendRequest/Authorization (Southwest Virginia Community College)

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WirelessCommunicationStipendRequest/Authorization



REQUEST/AUTHORIZATIONFORM  

SECTION1:EmployeeInformation SECTION2:ChargeCode

EmployeeName:



EmployeeID: AISChargeCode:

DepartmentName:



OfficePhone#: GrantCode(ifapplicable):

CurrentSWCCCellPhone#:

SWCCCellPhoneTermination Date: CellPhone#CoveredbyStipend:



SECTION3:StipendRequest(checkallthatapply)



MonthlyStipend



MonthlyVoicePlanLevel1(450minutesorless) $ 40.00



MonthlyVoicePlanLevel2(450to900minutes) $ 60.00



MonthlyVoicePlanLevel3(over900minutes$ 75.00



MonthlyDataPackage(ifdatausageisneeded) $ 20.00



MonthlyTextMessaging(forunlimitedtext) $ 10.00



Bi‐annualphoneequipmentallowance$ 50.00



Bi‐annualphone/dataequipmentallowance

$ 200.00



MonthlyMobileInternetService(wirelessaircard) $ 60.00



MonthlyInternetServiceOther*$_

Totalmonthlystipendrequested...........................................................................................................

$______

Totalstipendrequested.........................................................................................................................

$______

+

Forbi‐annualequipmentallowance,usethisformandattachacopyoftheinvoice/receipt.Thisstipendcanonlyberequestedeverytwoyears.

*Foradditionalmonthlystipend,pleaseprovideadescriptionofwhyitisnecessaryandwhatitwillbeusedforbelow:



SECTION4:Justification(checkallthatapply)





Theemployee’sjobrequiresthattheyworkregularlyinthefieldandneedtobeimmediatelyaccessible.



Theemployee’sjobrequiresthattheyneedtobeimmediatelyaccessibleoutsideofnormalbusinesshours.



Theemployeeisresponsibleforcriticalinfrastructureandneedstobeimmediatelyaccessibleatalltimes.



Theemployeetravelsandneedstobeaccessibleorhaveaccesstoinformationtechnologysystemswhiletraveling.



Accessviavoiceandoraccesstoinformationtechnologysystemsviaamobilecommunicationsdevicewould,inthejudgeof

thesupervisor,rendertheemployeemoreproductiveand/ortheservicetheemployeeprovidesmoreeffective,andthecost

ofmobilecommunicationsserviceisthereforewarranted.



IherebycertifythatallinformationistrueandthatIhavereadandunderstandtheSouthwestVirginiaCommunityCollegeWireless

CommunicationStipendPolicy.Iunderstandthefollowing:



1. ThestipendforwirelesscommunicationispaidthroughSWCCpayroll.

2. Stipendrateswillbereviewedandapprovedeachfiscalyear.

3. Thestipendwillbeconsideredtaxableincome.

4. ThemonthlystipendallowancecoversSWCCbusiness‐relatedcosts.

5. Iamresponsibleforpurchasingthewirelesscommunicationdeviceandserviceplan:Thedeviceismypersonalproperty.

6. Thestipendisnotconsideredpartofmybasepay.

7. Ifmywirelessdeviceisnolongeractiveorneededformyjobresponsibilities,ImustnotifyHumanResources.



EmployeeSignature:____________________Date:_______SupervisorSignature:____________________Date:_______



SECTION5:SignatureApprovals



President(ordesignee)DateVicePresidentofFinanceDate



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Completed 27 July 2020

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