Policy Manual 9.2013 - Tijuana Flats

TIJUANA FLATS CELL PHONEDEDUCTION AUTHORIZATION FORMEmployee Name:_____________________________________________Department:_____________________ Title:_______________________Cell Phone Number:___________________________________________Additional Cell Phone Services Requested:Sprint Hot Spot ($29.99 plus tax monthly)Sprint Phone Insurance ($8.00 plus tax monthly)NoneAgreement for Payroll Deductions:I authorize TJF Management to deduct the costs of those services selected above, as well as any otherservices or charges not covered by the corporate cell phone plan including but not limited to directoryassistance, downloads, and call forwarding, from my bi-weekly paycheck. I understand that if I selectnone, I do not wish to have any additional services and any services that currently are attached to myphone number will be cancelled. I understand that if I have other charges to my phone number, I will beresponsible to pay those through a payroll deduction on the following paycheck.____________________________________________________Employee Signature_______________________DatePolicy Manual-Confidential9/5/2013Return to Top 87