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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2005-04-01
Purpose: Quarterly expense report
Reference: 2005-GRICF-01

Date Category* Description Amount
Various    Health    Group therapy (9 x $12)   $108.00
2005-01-01    Health    Insurance - Jan   $195.00
2005-01-05    Health    Prescription   $285.00
2005-01-06    Health    Medical companion flight ($AU 1637.92)   $1277.58
2005-01-06    Account fees    Wire fee   $38.00
2005-01-11    Grants    Association for India's Development   $1000.00
2005-01-11    Grants    Consumer Project on Technology (c/o Essential Information)   $500.00
2005-01-11    Grants    RESULTS Educational Fund   $500.00
2005-01-11    Grants    Treatment Action Campaign (c/o South Africa Development Fund)   $500.00
2005-01-11    Grants    HealthGAP Coalition (c/o Mobilization Against AIDS)   $500.00
2005-01-12    Travel    CWRU interview: SFO - Cleveland, OH return   $364.80
2005-01-13    Health    Prescription   $35.00
2005-01-16    Health    Prescription   $10.00
2005-01-20    Health    Dentist   $20.20
2005-01-24    Health    Psychiatrist   $25.00
2005-02-02    Grants    Association for India's Development   $1000.00
2005-02-02    Grants    IDEX   $1500.00
2005-02-02    Grants    Oxfam America   $500.00
2005-02-06    Office    Hosting for gricf.org - 1 month   $3.95
2005-02-07    Health    Insurance - Feb   $195.00
2005-02-16    Health    Psychiatrist   $25.00
2005-02-17    Health    Prescription   $35.00
2005-02-22    Health    Prescription   $10.00
2005-03-05    Health    Insurance - Mar   $195.00
2005-03-06    Office    Hosting for gricf.org - 1 month   $3.95
2005-03-06    Travel    Meals/incidentals per diem (3.5 x $47.00/day)
  General Services Administration Cleveland OH rate  
$164.50
2005-03-07    Health    Dentist   $79.40
2005-03-07    Health    Prescription   $10.00
2005-03-08    Pubs    Malaria   $80.99
2005-03-12    Health    Hospitalization - 7 days   $1400.00
Total expenses   $10561.37
Less advances   $0
Reinbursement due   $10561.37

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.405/mile, lodging, M&IE

Comments:

Signature:

Approved by: Marantha de Araujo

Signature:

Date: 2005-04-01