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

Expense report / Reinbursement request

Submitted by: John Iverson
Date: 2004-07-29
Purpose: Attend International AIDS Conference - Bangkok, Thailand
Reference: 2004-GRICF-04

Date Category* Description Amount
2004-07-02    Travel    Airfare   $928.49
Total expenses   $928.49
Less advances   $0
Reinbursement due   $928.49

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.365/mile, lodging, M&IE

Comments:

Signature:

Approved by: Marantha de Araujo
Date: 2004-07-29
Signature: