HomeMy WebLinkAboutExp-12.2011-SattlerWGeorgetown
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City Council Member Statement of Expenses or Lost Irk
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Council Member's name:
E OWN
For the month of , 20 l hereby certify to _ n
following expenses and/or lost income related to exercising racy duties as a Council member.
Io EXPENSES;
X
Please fill out sections a - d below and check taxable or non-taxable,
X
(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:
**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
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III, TOTAL REIMBURSEMENT
In no case can the amount of reimbursement exceed $100 per month.
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