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

Expense report / Reinbursement request

Submitted by: John Iverson
Date: 2003-12-16
Purpose: Attend Global Network of People Living With AIDS Conference - Kampala, Uganda
Reference: 2003-GRICF-04

Date Category* Description Amount
various    Travel    Accomodation   $216.34
various    Travel    Meals and incidental expenses   $87.20
various    Pubs    Photocopy flyers   $218.89
Total expenses   $522.43
Less advances   $0
Reinbursement due   $522.43

* - 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: 2003-12-16
Signature: