HomeMy WebLinkAboutExp-08.16.2010 thru 09.15.2010-MeigsCity
City Council Member Statement of Expenses or Lost Income
Council Member's Name:
For the month of
AD I hereby certify that I have the
following expenses and/or lost income related to exercising my duties as a Council member.
a,
I. EXPENSES: M
Please fill out sections a - d below and check taxable or non-taxable. s`B
X
X C
o
(a.) Phone expenses: $
(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:
$ E] 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 hours -spent = Lost Income
X
III. TOTAL REIMBURSEMENT
In no case can the amount of reimbursement exceed $800 per month.
Signed on the day of 2
e
signature
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6