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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2005-06-27
Purpose: Quarterly expense report
Reference: 2005-GRICF-02

Date Category* Description Amount
Various    Health    Group therapy (5 x $12)   $60.00
2005-04-01    Health    Prescription   $35.00
2005-04-04    Occupancy    Office rent - 3/30 x $550   $55.00
2005-04-05    Health    Insurance - Apr   $195.00
2005-04-06    Office    Hosting for gricf.org - 1 month   $3.95
2005-04-10    Travel    CWRU reinbursement   $-457.80
2005-04-20    Health    Psychiatrist   $25.00
2005-04-21    Health    Lab test   $10.00
2005-04-24    Health    Prescription   $90.00
2004-04-28    Travel    Foundation meeting - 46 miles
  326 A St - 2021 The Alameda, San Jose - return  
$18.63
2004-04-28    Travel    Marcy foundation meeting - 34 miles
  home - 2021 The Alameda, San Jose - return  
$13.77
2004-04-28    Legal    Meeting   $300.00
2005-05-05    Health    Insurance - May   $195.00
2005-05-06    Office    Hosting for gricf.org - 1 month   $3.95
2005-06-05    Health    Insurance - June   $195.00
2005-06-06    Office    Hosting for gricf.org - 1 month   $3.95
2005-06-12    Office    Hosting for gricf.org - 12 month   $33.18
2005-06-20    Health    Dentist   $49.20
Total expenses   $828.83
Less advances   $0
Reinbursement due   $828.83

* - 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: 2005-07-01