HomeMy WebLinkAboutExp-06.2011-SattlerCity of Georgetown
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Council Member's fame:
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For the month of % y N , 20 f , 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.) `�Sb 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:
$ E 00
$2 S Ex I
$ 0 El
$ 0 El
$ 0 El
"These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
11. LOST INCOME
(e.) Hourly rate X hours spent = Lost Income
X = 0.00 $
III. TOTAL REIMBURSEMENT
In no case can the amount of reimbursement exceed $800 per month.
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Signed on the _ day of 'J L)
signature
20 -LL.
$
X
x
a
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z
$ E 00
$2 S Ex I
$ 0 El
$ 0 El
$ 0 El
"These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
11. LOST INCOME
(e.) Hourly rate X hours spent = Lost Income
X = 0.00 $
III. TOTAL REIMBURSEMENT
In no case can the amount of reimbursement exceed $800 per month.
7J
Signed on the _ day of 'J L)
signature
20 -LL.
$