WVDDC > About Us > Council Member Expense Form

 Council Member Expense Form 

Name: * Address: * Phone: Travel Purpose: * Travel Start Date: * TravelStartDate Date Travel End Date: * TravelEndDate Date Mileage: Total Mileage Expense (Miles X $.405): $ Other: Total Other Expense: $ Tolls: $ Meals: $ Lodging: $ Respite Care: $ Personal Assistance: $ Per Diem ($75.00) (Quarterly Meetings Only): I do accept I do not accept Total Expenses: * Please email, fax, or mail copy of all receipts to the WVDDC office. $

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