HomeMy WebLinkAboutExp-04.2012-Sattler-Part2tA
Council Member's Dame: _ €
For the month of
( L. , 20 1 1 hereby certify that
following expenses and/or lost income related to exercising my duties as a Council member,
ff ry
A LU U,
1. EXPENSES: X
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Please fill out sections a - d below and check taxable or non-taxable.
M I
XC
M a
a- z
(a.) Phone expenses: $ El ❑**
(b.) z.` 0 miles at I.R.S. rate: $. SE per mile $ ` ®**
(c.) Home office expense for area set aside for City business: $Ex I
(d.) Other expenses - Please itemize below:
$ El 0**
$ 0 F
$ El 0**
"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 = 0.00 $ F]
r
III, T'OT'AL REIMBURSEMENT
In no case can the amount of reimbursement exceed $00 per month.
Signed on the Z41 day of I 1 C-
1 .°
signature
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