The Gordon R. Irlam Charitable Foundation
326 A St
Redwood City, CA 94063

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2003-06-30
Purpose: Quarterly expense report
Reference: 2003-GRICF-02

Date Category* Description Amount
2003-04-04    Health    Taxi
  Langley Porter, SF - Pickwick hotel, SF  
$15.00
2003-04-04    Health    Hotel room for 3 nights   $197.16
2003-04-04    Health    Taxi
  Pickwick hotel, SF - 326 S St  
$100.00
2003-04-04    Health    Prescription   $187.30
2003-04-05    Taxes    2001 990PF late payment fee   $3.69
2003-04-07    Grants    Global AIDS Interfaith Alliance   $50.00
2003-04-09    Health    Psychologist   $120.00
2003-04-11    Travel    Borderless Giving Conference fee   $350.00
2003-04-11    Grants    NAMI San Mateo County   $50.00
2003-04-19    Health    Prescription   $338.50
2003-04-24    Health    Insurance - May 2003   $221.00
2003-04-29    Health    Psychologist   $120.00
2003-05-01    Travel    RESULTS Educational Fund Conference airfair   $272.50
2003-05-02    Travel    RESULTS Educational Fund Conference fee   $360.00
2003-05-02    Office    Inkjet color cartridge   $23.80
2003-05-02    Grants    BREAD (ISEC) membership returned   $-100.00
2003-05-02    Health    Insurance - May 2003 (new plan)   $178.00
2003-05-02    Health    Book on health condition   $11.48
2003-05-02    Health    Book on health condition   $43.25
2003-05-02    Health    Book on health condition   $64.49
2003-05-03    Health    Books on health condition   $50.35
2003-05-03    Health    Book on health condition   $49.49
2003-05-03    Health    Books on health condition   $5.85
2003-05-03    Health    Books on health condition   $42.77
2003-05-07    Health    Psychologist   $125.00
2003-05-08    Office    2 Inkjet black cartridge   $57.23
2003-05-22    Health    Psychologist   $130.00
2003-05-23    Health    Psychiatrist copay   $20.00
2003-05-23    Health    Psychologist   $135.00
2003-05-27    Health    Psychologist   $480.00
2003-05-28    Pubs    Book - Where there is no doctor   $23.09
2003-05-29    Health    Psychologist   $135.00
2003-05-29    Health    Group therapy copay   $20.00
2003-06-03    Health    Psychologist   $120.00
2003-06-03    Pubs    Subscribe Third World Resurgence   $45.00
2003-06-05    Travel    Conference parking   $11.00
2003-06-07    Health    Prescription copay   $35.00
2003-06-07    Health    Ambulance copay   $75.00
2003-05-29    Health    Psychologist   $135.00
2003-05-29    Health    Group therapy copay   $20.00
2003-06-13    Travel    Meals/incidentals per diem (5 x $46.00/day)
  General Services Administration Washington DC rate  
$230.00
2003-06-19    Health    Psychiatrist copay   $20.00
2003-06-19    Health    Group therapy copay   $20.00
2003-06-23    Health    Psychologist   $135.00
2003-06-24    Health    Insurance - July 2003   $135.00
2003-06-26    Health    Group therapy copay   $20.00
2003-06-30    Health    Psychologist   $135.00
Total expenses   $5015.95
Less advances   $0
Reinbursement due   $5015.95

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.365/mile, lodging, M&IE

Comments:

Signature:

Approved by: Marantha de Araujo
Date: 2003-06-30
Signature: