HomeMy WebLinkAboutExpense Report-10.2010-Gonzalez,TommyGeorgetownCity of
For the month of -`, , 20 ,1 hereby certify that I have the
following expenses and/or lost income related to exercising my duties as a Council member.
1. EXPENSES: M
Please fill out sections a - d below and check taxable or non-taxable.
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(a.) Phone expenses:
(b.) miles at I.R.S. rate: $.50 per mile $ l '_
(c.) Home office expense for area set aside for City business:
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(d.) Other expenses - Please itemize below:
**These items can be reimbursed non-taxable per IRS guidelines when detailed receiots or mileage
reports are attached to this form.
11. LOST INCOME
(e.) Hourly rate X hours spent = Lost Income
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Ill. TOTAL REIMBURSEMENT $ > u->
In no case can the amount of reimbursement exceed $800 per month.
Signed on the day of, s,(rz?. O%'y'"'. 20
signature
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