HomeMy WebLinkAboutExp-12.2011-MeigsCity of Georgetown
City Council Member Statement of Expenses or Lost Income
Council Member's Name: DArV_Atj
For the month of &X.A&, 20 j ( 1 hereby certify that I have the
following expenses and/or lost income related to exercising my duties as a Council member.
v
I. EXPENSES:
Please fill out sections a - d below and check taxable or non-taxable.
X =
0 0
(a.) Phone expenses: $ El El
(b.) miles at I.R.S. rate: $.555 per mile $ 0 El
(c.) Home office expense for area set aside for City business: $ E71
(d.) Other expenses - Please itemize below:
$ 0**
$ 0 E**
$ 0 El
**These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
II. LOST INCOME
(e,) Hourly rate X hspent =lLos�t Income
„ x o s _1 0.00 $ 00
II. TOTAL REIMBURSEMENT $ Lo
In no case can the amount of reimbursement exceed $100 per month.
Signed on the day of 120
signature