| Submitted by: | Gordon Irlam |
| Date: | 2004-12-31 |
| Purpose: | Quarterly expense report |
| Reference: | 2004-GRICF-06 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2004-10-01 | Health | Dentist | $70.60 |
| 2004-10-06 | Office | Grad school application postage | $12.49 |
| 2004-10-09 | Health | Glasses | $196.00 |
| 2004-10-13 | Programs | GRE transcripts | $75.00 |
| 2004-10-13 | Programs | UCB transcripts | $35.00 |
| 2004-10-13 | Programs | UCSC transcripts | $35.00 |
| 2004-10-13 | Programs | Adelaide Uni transcripts | $18.02 |
| 2004-10-16 | Programs | UCSD application | $60.00 |
| 2004-10-16 | Health | Insurance | $177.00 |
| 2004-11-10 | Programs | UW-Madison application | $45.00 |
| 2004-11-10 | Programs | UCB application | $60.00 |
| 2004-11-10 | Programs | UCSF application | $60.00 |
| 2004-11-10 | Programs | Stanford application | $100.00 |
| 2004-11-16 | Health | Prescription (co-pay) | $35.00 |
| 2004-11-17 | Health | Insurance | $177.00 |
| 2004-11-24 | Health | Dentist | $1161.50 |
| 2004-11-27 | Health | Prescription (co-pay) | $10.00 |
| 2004-12-01 | Health | Lab test (co-pay) | $10.00 |
| 2004-12-03 | Pubs | Schaum's Zoology | $6.18 |
| 2004-12-07 | Health | Psychiatrist | $25.00 |
| 2004-12-08 | Health | Psychiatrist | $25.00 |
| 2004-12-15 | Health | Prescription (co-pay) | $35.00 |
| 2004-12-17 | Health | Prescription | $9.85 |
| 2004-12-23 | Health | Dentist | $44.00 |
| Total expenses | $2482.64 | ||
| Less advances | $0 | ||
| Reinbursement due | $2482.64 | ||
| * - 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: | 2004-12-31 |
| Signature: |