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INDIAN RIVER COL94TY <br />CHILDREN'S SERVICES ADVISORY COMMITTE <br />REMBURSEMENT REQUEST - FY25.26 <br />Agency PwWarri <br />AdJress Mone <br />Email 4.4. <br />REQUEST <br />>ayrnent <br />Tax Employer <br />Retirement Employer <br />Total <br />Percentage <br />Date <br />Payee/Vendor <br />P2y Period <br />Gross Salary <br />Contribution <br />Contribution <br />caiculLated <br />ofTotal tobe <br />Total kequ-2sted <br />Requested <br />'Remove sick, PTO. <br />aAd,lor Holidays not <br />contributior. is <br />recognized by the <br />feitc-cied in gross <br />County. <br />10D%. <br />100%. <br />S <br />10(y-riL` <br />5 <br />S <br />10W <br />S <br />10(m <br />S <br />S <br />S <br />S <br />S <br />'s <br />Is <br />S <br />Expurtses i nust in2lude itet mzud ui igAi iat irivuicc im J i L -,-,c ipL L;.i cai CeLed check as pi uuf U1 paym Uri.. <br />S;ilarios must show a breakdown Me hours paid by type le -g- regular. sick, vacation). l3teasu note the County will r*X Reirnlbuirw for SICK u; VACATYDN <br />11rn so those must be deducted lium Ow rocluesi iaior to submitting <br />