HomeMy WebLinkAboutExp-09.2011-Sattler4
Council Member's Named
For the month of :P e = A4 A e. , 20 , ! hereby certify th
following expenses and/or lost income related to exercising my duties as a Council
EXPENSES:
Please fill out sections a - d below and check taxable or non-taxable.
(a.) Phone expenses:
miles at O.R.S. rate; $ per mile
4IC ( 2 0 4C3
l have the
5
(c.) Houde office expense for area set aside for City business.
(d.) Cather 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.
D El
II, LOST ICC?NI
(e.) Hourly rate X hours spent = Lost Income
X - 0.00 $EX I
III. TOTAL REIMBURSEMENT
ENT
In no case can the amount of reimbursement exceed $800 per month.
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Signed on the 20
_ day of �,
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