e c 0 c 2: u. i c ece v c 0 a - brazeau county2015/12/31 · • so ame month endedf4tt3qc s name...

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Board Honoraria/Expense Claim Form

Approved by:

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I herety certify that the whole of the eapeniture was incuryad — C - ro that each tern e -- and that am ounts claimed hate not previously been paid to me

or on my behalf.

ELECTED OFFICIALS/BOARD- HONORARIA/EXPENSE - CLAIM FORM.

5I( \A RE: DATE:

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MONTH ENDED: Oc.

TIME COUNOL ADMIN ‘COtWENT.

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C’ 15 APPROVED BY:

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ASE LAWS] MELCARB

DAS OTHER KMS MEALS HOTEL OTHER

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Communication Allowance month— — 75.00

Preparation. Rate Payers Concerns x 2 doss/month

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TLThTAL EXPENSES a 3 qA-li: : licE WAS INCURREDONCOUNfl BUSINS.TUECH ITEM C :EN 5 JliOEC 4’THAT OUCIMED HAVENOTPREVSLY8EEN PAIDTOMEOR MV BEHAE

TOTAL CLAIM 1.

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Date:

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Signature:

Board Name Los) w9c3CMonth Ended

Name

aApproved by:

Date Details Time Honoraria Mileage Other Expenses — — MEALShml Hotel Other B L I) $ Ant

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I heeby ceenfy that the wtde of 11w expenolure was axurred on county business that each item correct, and that amtun claimed hate tnt previously been paid to me

TotalHonoraria IITotal ExpensesTotal Mileage $ tD -

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ELECTED OFFICIALS/BOARD - HONORARIA/EXPENSE - CLAIM FORM

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MONTH ENDED;

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TIME CONVENT. ASB MR SOAR OTHER <MS I MEALS

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—•. -• - -T - --TOTAL EXPENSES LXZEOFTHE *CE.AS CURE0 ON COUNTYBUSINESSTHATEAC” E.GIVEN ISCORREq ANDTHATAMOUNThCL.MMEDHAVE NOTPREVIOUSLY BEEN PAIDTOMEORONMYBEHALF.

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__________________________________________

DATE:

___________________________________________________

TOTAL CLAIM:

____________

INK POT IZ1• 16348-j


Total Honoraria S 4) ?— CPTotal Expenses _J__Total Mileage (,; L- r’)

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Approved by:

Date Details lime Honoraria Mileage Other Expenses MEALSHotel Other I D $AmtDr.,4_ $0f33 HaM ?ii OtCID

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TOTALS 5CL /Notes

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I hereby certify that the whole tf the expenditure was incurred on County businean. that each tern g.ver. is correct, and that am ounts claimed hate not prevIousiy been paid tomeor on my behaif. Sienature: C/

ELECTED OFECALS/BOARD - HONORARIA/EXPENSE- CLAIM FORM

P ILSTIME COUNCIL ADMIN CONVENTS .SS OODLOT MPC DAB OTHER <VS MEALS______ HOTEL OTHERF D E

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communication Allowance/month— — — 75.00

veembon/Rate Payers Concerns x 2 days/morth

TOTAL

‘tL. - 1,6 kms 9- 33 Q)TOTAL HONORARtA

- .- TOJALA/ P_3I HEREBYCERTIFYUMTThE WHOLEOFTHE ExPE-NDITLRE\AS INCURRED ON MD SLS’NESS, THTEACH ITEM GIvEN IS CORRECT AND THAT AMDLNTS CLAIMED HAVE NOT PREVIOUSLY BEEN PAID TO MEOR ON MY BEHALF

Allah CypJJpr MONTH ENDED: 0 € C t tt APPROVED BY:

ray 13 .Acccunts Payable

SIGNATURE: g4 a’ DATE: L2&.. JLr2O/S TOTAL CLAIM: So

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DATE

MONTH ENDED: C\ APPROVED BY:

LARB/ MPC DAB - OTHER KMS MEALSCARBB L D SAMT

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Pn.iPawnConcemsx2 days/month— — —

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TQTALHONORAmA TOTAL EXPENSESI UE : CEREFY1)W1TfWHOIE 1WDIWREWMINCURRWON COUNIVBUSINESS,THATEACH ([EM GIVEN iS CORREcT, ANDThAT AMOUNTS CLAWED HAVE NOT PREVIOUSLY BEEN PAIDTO ME ORON MY BEHALF.

DWC:

____________________________________________

TOTALCLA!M:

_____________________

DETAILSTIME COUNCIL

Payroll

ADMIN COrNENT. ASB HOTEL OTHER

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MONTH ENDE 2€: /3 APPROVED BY

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DA’E DETAILST’ME COUNCIL ADMIN C0NVENT ASB LARB! MPC DAB OTHER KMS

LMEALS HOTEL OTHER

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Cnmmu,*ation Allowance/month— 75.00

Preparation/Rate Payers Concerns x 2 days/month

ZTL I____ 67

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TOTAL HONORARIA TOTAL EXPENSES

-

I CEH -c:EwhcLEomE EXPENDfflJREWASlNCUAREDONCOUN1YBUSiNE5SjAPC— E’.’ C MEN SCORRECTANDTHAAMOUNThCLAIAED HAVENOTPREVIOUSLY SEEN PAID1O ?.E ORON ?AY eEHALF.

S!CNATMPE

_______

DATE: -%(> 7-7 - ?- fS TOTAL CLAIM: 9PT IF 04383

e c 0 c 2: u. i c ece v c 0 a - brazeau county2015/12/31 · • so ame month endedf4tt3qc s name...

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