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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2014-12-31
Purpose: Quarterly expense report
Reference: 2014-GRICF-04

Date Category* Description Amount
2014-10-03    Health    Group   $270.00
2014-10-05    Health    Insurance   $564.00
2014-10-09    Health    Therapy   $185.00
2014-11-05    Health    Insurance   $564.00
2014-11-06    Health    Therapy   $185.00
2014-11-09    Health    Group   $270.00
2014-11-25    Health    Dentist   $290.00
2014-12-04    Health    Therapy   $185.00
2014-12-05    Health    Insurance   $564.00
2014-12-16    Health    Group   $185.00
Total expenses   $3262.00
Less advances   $0.00
Reinbursement due   $3262.00

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.565/mile, lodging, M&IE

Signature:

Approved by: Purobi Phillips

Signature:

Date: