HomeMy WebLinkAboutExp-12.2010-SattlerCity of Georgetown
City Council Member Statement of Expenses or Lost Income
Council Member's Name:
For the month of
, 20 10, 1 hereby certify that I have the
following expenses and/or lost income related to exercising my duties as a Council member.
1. EXPENSES:
Please fill out sections a - d below and check taxable or non-taxable.
(a.) Phone expenses:
(b.) I (v -Z. miles at I.R.S, rate: $.50 per mile
(c.) Home office expense for area set aside for City business:
(d.) Other expenses - Please itemize below:
FFIc P r 0 t
$ -7 El Q**
$ (fyv 0 Fx l**
$ " .� 0
$_ El ®**
$ El El
$ Il El
"These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
Il. LOST INCOME
(e.) Hourly rate X hours spent = Lost Income
X = 0.00 $ 51
. 5'e>
Ill, TOTAL REIMBURSEMENT $
In no case can the amount of reimbursement exceed $800 per month.
t t i't
Signed on the day of 20 I
signature
v
.a
F1'
m
X
=
m
4
r-
z
$ -7 El Q**
$ (fyv 0 Fx l**
$ " .� 0
$_ El ®**
$ El El
$ Il El
"These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
Il. LOST INCOME
(e.) Hourly rate X hours spent = Lost Income
X = 0.00 $ 51
. 5'e>
Ill, TOTAL REIMBURSEMENT $
In no case can the amount of reimbursement exceed $800 per month.
t t i't
Signed on the day of 20 I
signature