The Gordon R. Irlam Charitable Foundation

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2023-04-07
Purpose: Quarterly expense report
Reference: 2023-GRICF-01

Date Category* Description Amount
2023-01-01    Health    Prescription   $37.11
2023-01-04    Health    Insurance   $897.00
2023-01-18    Health    Dentist   $156.00
2023-01-31    Health    Insurance   $753.57
2023-02-01    Health    Insurance   $897.00
2023-02-28    Health    Insurance   $753.57
2023-03-01    Health    Insurance   $897.00
2023-03-31    Health    Insurance   $753.57
Total expenses   $5144.82
Less advances   $0.00
Reinbursement due   $5144.82

* - Valid categories: Grants, Travel, Pubs, Office, Health, Programs, Other
Travel includes conf./meetings, transport, car-$0.575/mile, lodging, M&IE

Signature:

Approved by: Manjula Jonnalagadda

Signature:

Date: