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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2011-03-31
Purpose: Quarterly expense report
Reference: 2011-GRICF-01

Date Category* Description Amount
2011-01-05    Health    Insurance   $426.00
2010-01-08    Office    GRICF.ORG domain and hosting   $56.80
2011-02-05    Health    Insurance   $426.00
2010-02-10    Health    Prescription   $70.00
2010-02-10    Accounting    Tax return   $2000.00
2010-02-10    Taxes    Tax return   $773.00
2010-02-10    Filing fees    Tax return   $60.00
2010-02-16    Health    Group   $120.00
2010-02-16    Health    Doctor   $25.00
2008-02-19    Pubs    Grantmakers w/o Borders membership   $250.00
2011-03-05    Health    Insurance   $426.00
2011-03-09    Health    Group   $180.00
2011-03-21    Health    Dentist   $190.00
2011-03-23    Health    Prescription   $70.00
2011-03-23    Health    Prescription   $10.00
2011-03-09    Health    Therapy (12 x $170)   $2040.00
Total expenses   $7122.80
Less advances   $0.00
Reinbursement due   $7122.80

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.55/mile, lodging, M&IE

Signature:

Approved by: Purobi Phillips

Signature:

Date: