HomeMy WebLinkAboutExp-09.2010-SattlerCity :f Georgetown
.oy o , !
StatementCity Council Member Exj2enses 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.) 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:
r�jg a° 0
$ & � .
$it
**These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
F- Z
® F-1**
0 ® **
Ex
**
F]
0 El
11. LOST INCOME
(e.) Hourly rate X hours spent = Lost Income
X = 0.00 $ 0.00 F
111, TOTAL REIMBURSEMENT $ Z400
In no case can the amount of reimbursement exceed $800 per month.
Signed on the day of ' r 20.
lei
signature
�
x
x
c
c4
6
F- Z
® F-1**
0 ® **
Ex
**
F]
0 El
11. LOST INCOME
(e.) Hourly rate X hours spent = Lost Income
X = 0.00 $ 0.00 F
111, TOTAL REIMBURSEMENT $ Z400
In no case can the amount of reimbursement exceed $800 per month.
Signed on the day of ' r 20.
lei
signature