Expenses for Reimbursement. 52.3.1 Household Effects
Expenses for Reimbursement. Quarterly Expenditure Claims are due 45 days after the end of quarter. The county/city clerk must sign and date all pages. **Copies of a signature will not be accepted Must be mailed with ORIGINAL signatures. There are 3 sections. Quarterly Salary Claim Quarterly Fringe Benefits Claim Quarterly Expenditure Claim REMINDER: the percentage that was entered on the budget is the ONLY amount that is eligible Example: if the OEM only performs 80% of emergency management functions, only 80% of salary is to be turned in Please use the forms on the website List the 50% matching fund (i.e. General fund) Enter the required minimum hours set by County/City officials This is a fund name NOT a dollar amount. EMPG QUARTERLY SALARY CLAIM Employee Name List 50% Matching Fund(s): Jurisdiction Original signature I CERTIFY THAT ALL EXPENSES LISTED ON THIS FORM HAVE BEEN PAID AND WERE INCURRED BY PERSONNEL OF THE JURISDICTION EMERGENCY MANAGEMENT OFFICE AND THAT THESE EXPENSES WERE DIRECTLY RELATED TO OFFICIAL EMERGENCY PREPAREDNESS ACTIVITIES. Signature of Jurisdiction Clerk Date REMINDER: the percentage that was entered on the budget is the ONLY amount that is eligible Example: if the OEM only performs 80% of emergency management functions, only 80% of salary is to be turned in List the 50% matching fund (i.e. General fund) All benefit expenditures claimed are for the amount the county/city pays; not what was withheld from your paycheck Check number: this is the check number the city/county paid the contribution not your paycheck number. This is a fund name NOT a dollar amount. EMPG QUARTERLY FRINGE CLAIM Employee Name List 50% Matching Fund(s): Jurisdiction Check# Date State Retirement Insurance/ Unemployment Social Security Total Benefits $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Totals: $0.00 $0.00 $0.00 $0.00 Original I CERTIFY THAT ALL EXPENSES LISTED ON THIS FORM HAVE BEEN PAID AND WERE INCURRED BY PERSONNEL OF THE JURISDICTION EMERGENCY MANAGEMENT OFFICE AND THAT THESE EXPENSES WERE DIRECTLY RELATED TO OFFICIAL EMERGENCY PREPAREDNESS ACTIVITIES. Item: What is it? e.g. cell phone service, copier contract, etc.
Expenses for Reimbursement
