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Acknowledgement <br />A Cell Phone Plan and Use Acknowledgement Signature Form will be required to be completed <br />prior to any employee using a City -owned cell phone or receiving a cell phone allowance. <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 />I hereby choose the following: <br />❑ 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 />Name (Please Print) <br />My Phone Number is: <br />Employee Signature <br />My Provider is: <br />Date <br />Department Head Signature Date <br />City Administrator Signature Date <br />Page 113 of 151 <br />209 <br />