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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2008-12-31
Purpose: Quarterly expense report
Reference: 2008-GRICF-04

Date Category* Description Amount
2008-10-02    Accounting    Tax return and annual meeting   $6187.50
2008-10-02    Taxes    Tax return   $1083.00
2008-10-02    Filing fees    Tax return   $160.00
2008-10-03    Health    Prescription   $37.00
2008-10-05    Health    Insurance   $325.00
2008-10-11    Health    MedicAlert   $25.00
2008-11-05    Health    Psychiatrist   $208.00
2008-11-05    Health    Insurance   $325.00
2008-11-25    Health    Psychologist   $25.00
2008-11-25    Health    Psychiatrist   $25.00
2008-11-25    Health    Prescriptions   $135.00
2008-11-26    Health    Doctor's visits   $199.04
2008-12-05    Health    Insurance   $325.00
2008-12-18    Health    Group therapy - 3 x $12   $36.00
2008-12-22    Health    Doctor's visits   $181.76
2008-12-24    Health    Laboratory   $31.35
Total expenses   $9308.65
Less advances   $0.00
Reinbursement due   $9308.65

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.505/mile, lodging, M&IE

Comments:

Signature:

Approved by: Tracy Irlam

Signature:

Date: 2008-12-31