HomeMy WebLinkAboutExp-11.16.2010 thru 12.15.2010-MeigsCity
City Council Member Statement of Expenses or Lost Income
Council Member's Name:Si} �
For the month of A�' I
a11 file _.._......, .
,. 20 I hereby certify that I have
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following expenses and/or lost income related to exercising my duties as a Council mer6her.
a,
1.
EXPENSES:
Please fill out sections a - d below and check taxable or non-taxable. M
M
X
M Q
(a.) Phone expenses:
l
(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.
"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
X
III, TOTAL REIMBURSEMENT
In no corse cern the amount of reimbursement exceed $800 per month.
Signed on the day of 20
$ .00
$ 2.00
signature