The Gordon R. Irlam Charitable Foundation
1723 Karameos Dr
Sunnyvale, CA 94087

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2007-07-02
Purpose: Quarterly expense report
Reference: 2007-GRICF-02

Date Category* Description Amount
2007-04-02    Health    Dentist   $80.00
2007-04-05    Health    Insurance - April   $294.00
2007-04-07    Accounting    Tax return   $2000.00
2007-04-07    Taxes    Tax return   $195.00
2007-04-07    Filing fees    Tax return   $10.00
2007-04-09    Health    Prescription   $974.00
2007-04-05    Health    Insurance - May   $294.00
2007-05-18    Health    Psychiatrist   $235.00
2007-05-21    Health    Psychiatrist   $240.00
2007-06-05    Health    Insurance - June   $294.00
2007-06-26    Health    Insurance - Summacare   $2188.95
Total expenses   $6804.95
Less advances   $0.00
Reinbursement due   $6804.95

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.485/mile, lodging, M&IE

Comments:

Signature:

Approved by: Tracy Irlam

Signature:

Date: 2007-07-02