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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2020-03-31
Purpose: Quarterly expense report
Reference: 2020-GRICF-01

Date Category* Description Amount
2020-01-05    Health    Insurance   $721.00
2020-02-05    Health    Insurance   $721.00
2020-02-18    Health    Dentist   $220.00
2020-02-22    Health    Prescription   $40.00
2020-03-02    Health    Dentist   $210.00
2020-03-05    Health    Insurance   $721.00
2020-03-09    Health    Prescription   $18.34
2020-03-21    Accounting    Tax return   $2550.00
2020-03-21    Filing fees    Tax return   $60.00
2020-03-21    Taxes    Tax return   $1438.00
Total expenses   $6699.34
Less advances   $0.00
Reinbursement due   $6699.34

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.575/mile, lodging, M&IE

Signature:

Approved by: Manjula Jonnalagadda

Signature:

Date: