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<br /> <br />106 <br />221698v1 <br /> <br />As an employee that has been identified as being in a position that requires the use of a cell <br />phone, I acknowledge that I have received the City of Orono’s policy on Cell Phone Use and <br />understand that this receipt will be filed with my personnel records. <br /> <br />I hereby choose the following: □ I will use a city provided cell phone. <br /> □ I choose to use my personal cell phone. I understand that under current IRS regulations, <br />the reimbursement that I will receive is added to my taxable income. <br /> <br /> <br /> <br /> <br />_____________________________________ <br />Name (Please Print) <br /> <br /> <br /> <br />My Phone Number is: ___________________ My Provider is: ___________________ <br /> <br /> <br /> <br />________________________________ ___________________________ <br />Signature Date <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />