Cell Phone Usage Log
Information below must be compared to the monthly statement provided by the cell phone service provider. It is required that this log be completed when the taxable stipend
option is not used.
Business Device - Cell Phone Number: Employee Name:
Include Area Code Printed Name
In (Incoming Call); Out (Outgoing Call); Bus (Business Call); Per (Personal Call)
Additional rows may be inserted as needed.
Date Time In Out Bus Per Phone Number Name of Person Purpose (please keep this concise)
Certification and Signature:
The information listed on this Cell Phone Usage Log has been reviewed, is accurate, and represents the correct identification of personal or business related calls.
Signature of Employee Date
Signature of Designated Approver Date