HomeMy WebLinkAboutExp-11.2011-GarverCouncil Member's Name:
For the month of
following expenses
November
20
to exercising
11
, 1 hereby
duties as
certify that
U t EOR
a Council m&MTE �mm —,
and/or lost income related
my
la EXPENSES:
Please fill out sections a - d below and check taxable or non-taxable.
(a.) Phone expenses:
(b.) 228 miles at I.R.S. rate: $.555 per mile
(c.) Home office expense for area set aside for City business: $
Q)
X
cu X
X
o
D El
100 El D
(d.) Other expenses - Please itemize below:
$ D El
$^ El D**
"These items can be reirnbursed non-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
Ile LOST INCOME
(e.) Hourly rate X hours spent = Lost Income
x = 0.00 ' _ _ EE
J
Ill, TOTAL REIMBURSEMENT
In no case can the amount of reimbursement exceed $100 per month.
Signed on the _ 8th of December, 2011
signature
$ 100.00
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