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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2016-09-30
Purpose: Quarterly expense report
Reference: 2016-GRICF-03

Date Category* Description Amount
2016-07-05    Health    Insurance   $612.00
2016-07-13    Health    Group   $405.00
2016-07-13    Health    Group   $270.00
2016-07-28    Health    Therapy   $185.00
2016-08-05    Health    Insurance   $612.00
2016-09-01    Health    Prescription   $40.00
2016-09-05    Health    Insurance   $612.00
2016-09-08    Health    Therapy   $185.00
2016-09-15    Health    Dentist   $170.00
2016-09-19    Accounting    Annual meeting   $375.00
Total expenses   $3466.00
Less advances   $0.00
Reinbursement due   $3466.00

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.56/mile, lodging, M&IE

Signature:

Approved by: Manjula Jonnalagadda

Signature:

Date: