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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2000-12-31
Purpose: Quarterly expense report
Reference: 2000-GRICF-05

Date Category * Description Amount
2000-10-05    Health    Doctor's visit (co-pay) - Typhoid vaccination   $5.00
2000-10-05    Health    Psychologist - Clinical assessment   $400.00
2000-10-08    Office    Postage - Charitable tax status application   $4.29
2000-07-11    Health    Medicine - Trip to El Salvador   $10.67
2000-10-18    Health    Psychologist   $330.00
2000-11-03    Filing fees    California Statement of Officers filing fee   $20.00
2000-11-08    Health    Doctor's visit (co-pay) - Initial consultation   $5.00
2000-11-10    Health    Psychologist - Clinical assessment   $1195.00
2000-11-29    Health    Psychologist   $550.00
Total expenses   $2519.96
Less advances   $0
Reinbursement due   $2519.96

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.325/mile, lodging, M&IE

Comments:

Signature:

Approved by: Gordon Irlam
Date: 2000-12-31
Signature: