HomeMy WebLinkAboutExp-12.2011-GarverGeorge Garver
Council Member's Name:
following expenses and/or lost income related to exercising my duties as a Council member.
1. EXPENSES:
Please fill out sections a - d below and check taxable or non-taxable.
W
X
x
o
El D**
(b.) 216 miles at I.R.S. rate. $.555 per mile $ loo El E�**
I
(c.) Home office expense for area set aside for City business: $
(d.) {ether expenses - Please itemize below
$ El
El
**
$ **
$El D**
**These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
lie LOST INCOME
(e.) dourly rate X hours spent = Lost income
X = 0.00 $
116. TOTAL REIMBURSEMENT $ 1136.66
in no case can the amount of reimbursement exceed $100 per month.
Signed on the _ 12th Cray o ### 4 .; t T,
a
signature
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following expenses and/or lost income related to exercising my duties as a Council member.
1. EXPENSES:
Please fill out sections a - d below and check taxable or non-taxable.
W
X
x
o
El D**
(b.) 216 miles at I.R.S. rate. $.555 per mile $ loo El E�**
I
(c.) Home office expense for area set aside for City business: $
(d.) {ether expenses - Please itemize below
$ El
El
**
$ **
$El D**
**These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
reports are attached to this form.
lie LOST INCOME
(e.) dourly rate X hours spent = Lost income
X = 0.00 $
116. TOTAL REIMBURSEMENT $ 1136.66
in no case can the amount of reimbursement exceed $100 per month.
Signed on the _ 12th Cray o ### 4 .; t T,
a
signature