HomeMy WebLinkAboutExp-04.2012-Meigst
City of Georgetown
City Council Member Statement of Expenses or Lost Income
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Council Member's Name::
For the month of fLr 201 , 1 hereby certify that 1 have the
following expenses and/or lost income related to exercising my duties as a Council member,
a
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EXPENSES:
Please fill out sections a - d below and check taxable or non-taxable.
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X
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(a.) Phone expenses: $ 0 Q**
(b.) miles at I.R.S. rate: $.555 per mile $**
(c.) Home office expense for area set aside for City business: $ 0
(d) Other expenses - Please itemize below:
$ C1 F"
$ I1 0**
"These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
are attached to this form.
IL LOST INCOME
(e.) ourly�r'aaqte X hours spent = Lost Income
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3 x - b `0.00
Ill. TOTAL REIMBURSEMENT $ /L�
In no case can the amount of reimbursement exceed $100 per month.
Signed on the day of AltA120
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signature
MAY 02. 20q