| Submitted by: | Gordon Irlam |
| Date: | 2016-12-30 |
| Purpose: | Quarterly expense report |
| Reference: | 2016-GRICF-04 |
| Date | Category* | Description | Amount |
|---|---|---|---|
| 2016-10-05 | Health | Insurance | $612.00 |
| 2016-10-06 | Health | Therapy | $185.00 |
| 2016-11-03 | Health | Therapy | $185.00 |
| 2016-11-05 | Health | Insurance | $612.00 |
| 2016-11-11 | Health | Prescription | $20.00 |
| 2016-11-28 | Health | Dentist | $160.00 |
| 2016-12-01 | Health | Therapy | $185.00 |
| 2016-12-05 | Health | Insurance | $612.00 |
| Total expenses | $2571.00 | ||
| Less advances | $0.00 | ||
| Reinbursement due | $2571.00 | ||
| * - Valid categories: | Grants, Travel, Pubs, Office, Health, Programs, Other |
| Travel includes conf./meetings, transport, car-$0.56/mile, lodging, M&IE |
Signature:
| Approved by: | Manjula Jonnalagadda |
| Signature: | |
| Date: |