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Form T-1 <br /> <br /> LOG OF EXPENSES <br /> (Internal Use Only-to be attached to Direct Payment Claim) <br /> <br />I hereby request reimbursement of expenses incurred in the course of o~icial business for the City of <br />Pleasanton, as follows: <br /> <br /> Ill <br /> ~ ACCOUNT. <br /> DATE ATTACI~k'~ NATURE OF OFFICIAL BUSINESS AMOUNT <br /> YES NO mm' . m~ . oat=er . mot <br /> <br />SUBTOTAL BY ACCOUNT: <br />TOTAL EXPENSF.3: <br />IF, SS ADVANCES: $ <br />NET DUE ElVIPLOYEE I CITY (Circle One) $ <br /> <br />CLAIM SUB~ BY: <br /> <br />Signature ,, <br /> <br />Title <br /> <br />Date <br /> <br /> <br />