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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2013-12-31
Purpose: Quarterly expense report
Reference: 2013-GRICF-04

Date Category* Description Amount
2013-10-02    Accounting    Foundation annual meeting   $375.00
2013-10-05    Health    Insurance   $526.00
2013-10-23    Health    Dentist   $278.00
2013-10-29    Health    Dentist   $475.00
2013-11-04    Health    Dentist   $475.00
2013-11-05    Health    Insurance   $526.00
2013-11-07    Health    Group   $540.00
2013-11-07    Health    Group   $595.00
2013-11-10    Health    Prescription   $90.00
2013-12-05    Health    Insurance   $526.00
2013-12-18    Health    Group   $380.00
2013-12-18    Health    Therapy (10 x $185.00)   $1850.00
Total expenses   $6636.00
Less advances   $0.00
Reinbursement due   $6636.00

* - 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: