The Gordon R. Irlam Charitable Foundation
1723 Karameos Dr
Sunnyvale, CA 94087

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2005-09-27
Purpose: Quarterly expense report
Reference: 2005-GRICF-03

Date Category* Description Amount
2005-07-01    Health    Pill cutter   $2.69
2005-07-05    Health    Insurance - July   $195.00
2005-07-28    Health    Prescription   $23.95
2005-07-30    Health    4 x Psychiatrist   $520.00
2005-08-05    Health    Insurance - August   $195.00
2005-08-10    Accounting    Tax return   $2000.00
2005-08-10    Taxes    Tax return   $93.00
2005-08-10    Filing fees    Tax return   $55.00
2005-08-10    Office    Postage   $4.47
2005-08-11    Health    Dentist   $10.00
2005-08-13    Legal    Annual meeting   $1500.00
2005-08-21    Health    Perscription   $158.00
2005-09-01    Health    Psychiatrist   $120.00
2005-09-01    Health    Dentist   $60.00
2005-09-05    Health    Insurance - September   $195.00
2005-09-06    Health    Dentist   $152.00
2005-09-20    Health    Dentist   $120.00
2005-09-27    Health    Dentist   $28.00
Total expenses   $5432.11
Less advances   $0
Reinbursement due   $5432.11

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.405/mile, lodging, M&IE

Comments:

Signature:

Approved by: Marantha de Araujo

Signature:

Date: 2005-09-30