HomeMy WebLinkAboutExpense Report-01.2012-Gonzalez,Tommyf Georgetown
€ter Council Member Statement of Expenses or Lost income
Council Member's lame: � ���,
For the month of �j cm 0 20 d hereby certify that i have the
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following expenses and/or lost income relate to exercising my duties as a Council member,
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I. EXPENSES.
Please fill out sections a - d below and check taxable or non-taxable.
a
{a.} Phone expenses: E-1 El**
{b.}
miles at S.R.S. rate: $.555 per mileF1 ED
(c.) Home office expense for area set aside for City business:„ n,
(d.) Other expenses - please itemize below:
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D
F E7$'
I**These items can be reimbursed non-taxable per IRS guidelines when detailed recei}�ts or mileage
its are attached to this form.
III. LST INCOME
(e.) Hourly rate X hours spent = Lost Income
X - 0,00 $ v
A Ex I
{ I
Ill. TOTAL REIMBURSEMENT $
in no case cern the amount of reimbursement exceed $100 per n7onth.
Signed on the day of r` . (kr Gil 20
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C1 11Y OF GEORGE-Rovi
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C1 11Y OF GEORGE-Rovi
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