HomeMy WebLinkAboutExp-01.2012-SattlerCity of Georgetown
City Council Member Statement of Expenses or Lost Incoe
I9`3P
Council Members Name;,._.ic.. a
ifs 111 l�
For the month of $t 20 ' lt I hereby certify that I ale e f;''p ;I j
3 2
following expenses and/or lost income related to exercising my duties as a Council member.
N
1, EXPENSES:Ja
Please fill out sections a - d below and check taxable or non-taxable,
X
M 0
(a.) Phone expenses:
(b.) miles at I.R.S. rate: $.555 per mile
(c,) Home office expense for area set aside for City business:
(d.) Other expenses - Please itemize below:
I
I
I
I
$
"These items can be reimbursed non-taxable per IRS guidelines when detoiied receit is or mileage
reports are attached to this form.
1-- Z
ll. LOST INCOME
_.�
(e.) Hourly rate X hours spent = Lost Income
d
X = 0.00 $
Ill. TOTAL REIMBURSEMENT $ � "r
In no case can the amount of reimbursement exceed $100 per month,
r �--
Signed on the day of _ 20. "
signature