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

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2014-06-30
Purpose: Quarterly expense report
Reference: 2014-GRICF-02

Date Category* Description Amount
2014-04-03    Health    Group   $405.00
2014-04-03    Health    Prescription   $31.00
2014-04-05    Health    Insurance   $564.00
2014-04-10    Health    Therapy   $185.00
2014-05-05    Health    Insurance   $564.00
2014-05-08    Health    Therapy   $185.00
2014-05-10    Health    Group   $540.00
2014-05-27    Health    Dentist   $161.00
2014-06-02    Health    Prescription   $90.00
2014-06-05    Health    Therapy   $185.00
2014-06-05    Health    Group   $405.00
2014-06-05    Health    Insurance   $564.00
2014-06-27    Legal    Annual meeting   $1700.00
Total expenses   $5579.00
Less advances   $0.00
Reinbursement due   $5579.00

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.565/mile, lodging, M&IE

Signature:

Approved by: Purobi Phillips

Signature:

Date: