HomeMy WebLinkAboutExp-01.2012-MeigsCity of Georgetown
City Council Member Statement of Expenses or Lost Income
s
Council Member's Name:
For the month of 20 12-71 hereby certify that I have the
following expenses and/or lost income related to exercising my duties as a Council member.
I. EXPENSES: X
Q,
Please fill out sections a - d below and check taxable or non-taxable. 0
X IL
ra O
t— z
(a.) Phone expenses: $ 0 E-1**
(b.) miles at I.R.S. rate: $.555 per mile $ 0 El
(c.) Home office expense for area set aside for City business: $
(d.) Other expenses - Please itemize below:
$ 0 E**
$ E-1 0**
$ E-1 E-1
**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
f �
X 1 = 0.00
II. TOTAL REIMBURSEMENT $ / 1y—
In no case can the amount of reimbursement exceed $100 per month.
Signed on the day of 20
signature