Attachment II


Texas State University

Higher Threshold Personal Cellular Services Allowance Form



This form authorizes an employee an annual allowance that exceeds the threshold of $600.00 USD, for reimbursement for university use of their personal cell phone plan. Note: This allowance is intended to assist with the cost for usage of cellular service, and not necessarily to cover the total costs. (See Attachment I for Service Plans.)


In order to obtain a higher threshold allowance for an employee:


·         Please complete this form including the allowance amount and obtain the employee and appropriate department head signatures.

·         Submit Attachment II and PCR forms to the divisional vice president.

·         After review and approval, the divisional vice president should:

o   Review the Higher Threshold Personal Cellular Service Allowance Form with the president for approval;

o   If approved, return a copy of the approved allowance forms to the appropriate department head; and, 

o   Forward the approved PCR to:

§  Human Resources for staff, hourly student employees and graduate students in divisions other than VPAA; or, 

§  Faculty Records for faculty and graduate students in the VPAA division




Printed Name

Texas State PLID




Work Phone/Cell Phone



Account Manager

Allowance Amount



Justification for Higher Threshold:








Vice President


Allowance Amount  $




I have read UPPS No. 05.03.11, Wireless Cellular Communication Services, and understand:


1.    The associated employee responsibilities.

2.    That these allowances are considered taxable compensation subject to required tax withholdings; and,

3.    These allowances are NOT part of my base salary.






Employee’s signature                                                                     Date





Authorizing Signature                                                                    Date

Division Vice President

Director of Athletics            





Authorizing Signature                                                                    Date