The Gordon R. Irlam Charitable Foundation
326 "A" St
Redwood City, CA 94063

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2000-09-30
Purpose: Quarterly expense report
Reference: 2000-GRICF-03

Date Category * Description Amount
2000-07-11    Health    Prescription (co-pay) - Paxil   $10.00
2000-07-14    Health    Dentist (insurance gap) - 7 fillings   $319.00
2000-07-18    Health    Doctor's visit (co-pay)   $5.00
2000-08-02    Health    Psychologist   $110.00
2000-08-21    Health    Doctor's visit (co-pay) - Hepatitas A vaccination   $5.00
2000-08-24    Office    Books - COF: International Grantmaking Fundamentals Package   $127.16
2000-08-28    Health    Prescription - Chloroquine anti-malaria tablets   $43.35
2000-08-30    Health    Psychologist   $440.00
2000-09-05    Health    Doctor's visit (co-pay) - Typhoid vaccination   $5.00
2000-09-07    Travel    Foundation annual meeting - 46 miles
  326 A St - 2021 The Alameda, San Jose - return  
$14.95
2000-09-27    Health    Psychologist   $440.00
Total expenses   $1519.46
Less advances   $0
Reinbursement due   $1519.46

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.325/mile, lodging, M&IE

Comments:

Signature:

Approved by: Gordon Irlam
Date: 2000-09-30
Signature: