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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2009-12-29
Purpose: Quarterly expense report
Reference: 2009-GRICF-04

Date Category* Description Amount
2009-10-05    Health    Insurance   $341.00
2009-10-09    Health    Prescription   $70.00
2009-10-09    Health    Prescription   $70.00
2009-10-29    Pubs    Article on VL treatement cost effctiveness   $29.95
2009-11-05    Health    Insurance   $341.00
2009-12-04    Health    Dentist   $145.00
2009-12-07    Health    Insurance   $341.00
2009-12-29    Health    Group - 9 x $12.00   $108.00
2009-12-29    Health    Therapy - 10 x $110.00   $1100.00
Total expenses   $2545.95
Less advances   $0.00
Reinbursement due   $2545.95

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.55/mile, lodging, M&IE

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Signature:

Approved by: Purobi Phillips

Signature:

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