The Gordon R. Irlam Charitable Foundation
23 Coronado Ave
Los Altos, CA 94022

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2017-12-20
Purpose: Quarterly expense report
Reference: 2017-GRICF-04

Date Category* Description Amount
2017-10-05    Health    Insurance   $628.00
2017-10-12    Health    Therapy   $195.00
2017-10-17    Travel    Foundation annual meeting - 31 miles
  23 Coronado - 2021 The Alameda - ret.  
$16.59
2017-10-17    Accounting    Annual meeting   $375.00
2017-10-27    Filing fees    Statement of information   $20.00
2017-11-05    Health    Insurance   $628.00
2017-12-05    Health    Insurance   $628.00
2017-12-05    Health    Prescription   $20.00
2017-12-11    Health    Dentist   $160.00
2017-12-14    Health    Therapy   $195.00
Total expenses   $2865.59
Less advances   $0.00
Reinbursement due   $2865.59

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.535/mile, lodging, M&IE

Signature:

Approved by: Manjula Jonnalagadda

Signature:

Date: