HomeMy WebLinkAboutExp-06.2011-HellmannCity f Georgetown
City Council Member Statement of Expenses or Lost Income
Council Member's Name:
For the month of ,�} , 20 11 , 1 hereby certify that I have the
following expenses and/or lost income related to exercising my duties as a Council member.
EXPENSES:
Please fill out sections a - d below and check taxable or non-taxable.
(a.) Phone expenses:
miles at I.R.S. rate: $.51 per mile
(c.) . Home office expense for area set aside for City business:
(d.) Other expenses - Please itemize below:
$ It )C
61ED
"These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
are attached to this form
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(e.) Hourly rate X hours spent= Lost Income
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® x. 0,00
III. TOTAL REIMBURSEMENT I$ s
In no case can the amount of reimbursement exceed $800 per month.
Signed on the day of 2011
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61ED
"These items can be reimbursed non-taxable per IRS guidelines when detailed receipts or mileage
are attached to this form
((��iP►[+ta]►�1
(e.) Hourly rate X hours spent= Lost Income
1�
® x. 0,00
III. TOTAL REIMBURSEMENT I$ s
In no case can the amount of reimbursement exceed $800 per month.
Signed on the day of 2011
signatu
Q
E]
41 a