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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2019-06-29
Purpose: Quarterly expense report
Reference: 2019-GRICF-02

Date Category* Description Amount
2019-04-05    Health    Insurance   $674.00
2019-05-04    Accounting    Tax return   $2125.00
2019-05-04    Taxes    Tax return   $1480.00
2019-05-04    Filing fees    Tax return   $85.00
2019-05-05    Health    Insurance   $674.00
2019-05-06    Health    Doctor   $25.00
2019-05-06    Health    Prescription   $30.00
2019-05-23    Health    Dentist   $156.00
2019-06-02    Health    Prescription   $20.00
2019-06-05    Health    Insurance   $674.00
2019-06-11    Legal    Annual meeting   $1700.00
Total expenses   $7643.00
Less advances   $0.00
Reinbursement due   $7643.00

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.58/mile, lodging, M&IE

Signature:

Approved by: Manjula Jonnalagadda

Signature:

Date: