| Submitted by: | Gordon Irlam | 
| Date: | 2019-12-24 | 
| Purpose: | Quarterly expense report | 
| Reference: | 2019-GRICF-04 | 
| Date | Category* | Description | Amount | 
|---|---|---|---|
| 2019-10-05 | Health | Insurance | $674.00 | 
| 2019-10-22 | Accounting | Annual meeting | $375.00 | 
| 2019-10-27 | Filing fees | Statement of Information | $20.00 | 
| 2019-11-05 | Health | Insurance | $674.00 | 
| 2019-11-10 | Health | Prescription | $40.00 | 
| 2019-11-21 | Health | Periodontist | $156.00 | 
| 2019-12-05 | Health | Insurance | $674.00 | 
| Total expenses | $2613.00 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $2613.00 | ||
| * - 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: |