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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2004-06-30
Purpose: Quarterly expense report
Reference: 2004-GRICF-03

Date Category* Description Amount
Various    Health    Group therapy x 8   $96.00
2004-03-29    Health    Logistical phone calls while in hospital   $105.00
2004-03-31    Health    Dentist   $95.00
2004-03-31    Accounting    Tax return   $2000.00
2004-03-31    Taxes    Tax return   $117.00
2004-03-31    Filing fees    Tax return   $35.00
2004-04-02    Office    Postage   $3.87
2004-04-13    Health    Prescription (co-pay)   $35.00
2004-04-15    Health    Psychologist   $25.00
2004-04-29    Health    Prescription   $10.00
2004-06-17    Health    Psychologist   $25.00
2004-06-22    Travel    Talk: The Invisible People - 73 miles
326 A St - 2454 Telegraph, Berkeley - return  
$27.38
Total expenses   $2574.25
Less advances   $0
Reinbursement due   $2574.25

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.375/mile, lodging, M&IE

Comments:

Signature:

Approved by: Marantha de Araujo
Date: 2004-06-30
Signature: