HomeMy WebLinkAboutExp-04.2012-SattlerCity of Georgetown
City Council Member Statement of Expenses or Lost 1
Council Member's !Name:I L - -
For the month of (C 20 , 1 hereby certify that
following expenses and/or lost income related to exercising my duties as a Council member.
EXPENSES:
Please fill out sections a - d below and check taxable or non-taxable.
(a.) Phone expenses:
55-5'
(b.) 41'�61 miles at I.R,S. rate: $AN per mile
(c.) Home office expense for area set aside for City business:
(d.) Other expenses - Please itemize below:
AR 2 7212
( or GDv;RGE-1*0 N
v
ro
m
_v x
-Q F
X =
(0 Q
F 2
$ El El
$ Cjtt�0 FX
$
$ 0 El
$ ❑ El
"These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
Its LOST INCOME
(e.) Hourly rate X hours spent = Lost Income
X = 0.00 $
Ill. TOTAL REIMBURSEMENT [ems $
In no case can the amount of reimbursement exceed $&W per month.
Signed on the day of A� Pa d C._
2012
signature