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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2018-06-26
Purpose: Quarterly expense report
Reference: 2018-GRICF-02

Date Category* Description Amount
2018-04-02    Health    Periodontist   $170.00
2018-04-05    Health    Insurance   $658.00
2018-04-23    Health    Prescription   $20.00
2018-05-02    Accounting    Tax return   $2125.00
2018-05-02    Taxes    Tax return   $1454.00
2018-05-02    Filing fees    Tax return   $35.00
2018-05-05    Health    Insurance   $658.00
2018-06-05    Health    Insurance   $658.00
2018-06-06    Legal    Annual meeting   $1700.00
2018-06-18    Health    Dentist   $160.00
Total expenses   $7638.00
Less advances   $0.00
Reinbursement due   $7638.00

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.545/mile, lodging, M&IE

Signature:

Approved by: Manjula Jonnalagadda

Signature:

Date: