HomeMy WebLinkAboutExp-01.2011-MeigsCity of Georgetown
City Council Member Statement of Expenses or Lost Income
Council Member's Name: azi
For the month of J &V. , 20 t l , I hereby certify that 1 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:
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(b.) miles at I.R.S. rate: $.50 per mile
(c.) Home office expense for area set aside for City business:
(d.) Other e e
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nses - Pl se itemize below:
X
x
m r
X
� o
r- z
$ 0 E-1
s'
$
$
$
**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 11cpme
i X L
111, TOTAL REIMBURSEMENT
In no case can the amount of reimbursement exceed $800 per month.
Signed on the day ofiL7t20 t
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