HomeMy WebLinkAboutExp-09.16.2010 thru 10.15.2010-Meigs( 1
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City of Georgetown
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City Council Member statement of Expenses or Lost income;' €
Council Member's Name:
For the month ofp
__ _ , �± 20 , I herebv certify that 1 have the
following expenses and/or lost income related to exercising my duties as a Council member.
II. EXPENSES:
Please fill out sections a - d below and check taxable or non-taxable.
(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:
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x
X c
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f- z
$ E-1 0*
$ s C", [�
$ Cl El
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$
**These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
IID LOST INCOME
(e.) Hourly rate X hours pent = Lost Income
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f X 1t =y 0.00
EE X
III. TOTAL REIMBURSEMENT
In no case can the amount of reimbursement exceed $800 per month.
Signed on the day of 20.
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