Social Club Dues Paid by Employer »

Documentation of Business and Personal Use
Calendar Year ______

Employee Name________________________________

Employee Social Security Number__________________________________

 

IF BUSINESS USE:

Name of Social Club

Date of Use

Personal Use (Y/N)

Amount of Expenditure

Business Reason for Activity/Expenditure

Name and Business Relationship of Individual(s) Involved

           
           
           
           
           

Signed________________________________

Return to Fringe Benefit section 3.11.B "Club Memberships and Dues"

Return to Appendix A