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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2007-03-31
Purpose: Quarterly expense report
Reference: 2007-GRICF-01

Date Category* Description Amount
2007-01-03    Health    Copay   $15.00
2007-01-05    Health    Insurance - January   $294.00
2007-01-10    Health    Prescription   $974.00
2007-01-12    Health    Psychiatrist   $120.00
2007-01-14    Office    Renew domain name gricf.org for 1 year   $8.24
2007-01-26    Office    Web hosting for gricf.org for 7 months   $27.93
2007-01-29    Health    Copay   $15.00
2007-02-05    Health    Insurance - February   $294.00
2007-03-05    Health    Insurance - March   $294.00
2007-03-08    Health    Copay   $15.00
2007-03-20    Health    Copay   $20.00
2007-03-20    Health    Insurance   $2131.89
2007-03-29    Health    Psychiatrist   $360.00
2007-03-31    Health    OTC   $4.99
Total expenses   $4574.05
Less advances   $0.00
Reinbursement due   $4574.05

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.485/mile, lodging, M&IE

Comments:

Signature:

Approved by: Tracy Deskin

Signature:

Date: 2007-03-31