HomeMy WebLinkAboutExp-10.2011-MeigsCity of Georgetown
City Council Member Statement of Expenses or Lost income
Council Member's dame:
For the month of &40 120 , 1 hereby "certify that I have the
following expenses and/or lost income related to exercising my duties as a Council member.
Q
EXPENSES: W X.
Please fill out sections a - d below and check taxable or non-taxable:
X
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(a.) Phone expenses: $ EJ F7
(b:) miles at I.R.S. rate: $.555 per mile $ El E
(c.) Home office expense for area set aside for City business: $ E
(d.) Other expenses - Please itemize below:
$ El ED
$ Q EJ
$ 0 El
**These items can be reimbursednon-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
II. LOST INCOME
(e.)ourly rate X hours spent = Lost Income
x lA - 0.00 $ F
IOP. TOTAL REIMBURSEMENT $
In no case con the amount of reimbursement exceed $100 per month.
Signed on the day of 20.
signature
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