Submitted by: | Gordon Irlam |
Date: | 2012-12-31 |
Purpose: | Quarterly expense report |
Reference: | 2012-GRICF-04 |
Date | Category* | Description | Amount |
---|---|---|---|
2012-10-05 | Health | Insurance | $472.00 |
2012-10-20 | Health | Health condition journal | $250.00 |
2012-10-24 | Health | Dentist | $165.00 |
2012-10-24 | Health | Prescription | $90.00 |
2012-11-05 | Health | Insurance | $472.00 |
2012-12-05 | Health | Insurance | $472.00 |
2012-12-09 | Health | Group | $420.00 |
2012-12-31 | Health | Therapy (10 x $170) | $1700.00 |
Total expenses | $4041.00 | ||
Less advances | $0.00 | ||
Reinbursement due | $4041.00 |
* - Valid categories: | Grants, Travel, Pubs, Office, Health, Programs, Other |
Travel includes conf./meetings, transport, car-$0.55/mile, lodging, M&IE |
Signature:
Approved by: | Purobi Phillips |
Signature: | |
Date: |