The Gordon R. Irlam Charitable Foundation

Expense report / Reinbursement request

Submitted by: Gordon Irlam
Date: 2023-06-30
Purpose: Quarterly expense report
Reference: 2023-GRICF-02

Date Category* Description Amount
2023-04-03    Health    Insurance   $897.00
2023-04-06    Health    Prescription   $37.11
2023-04-24    Health    Dentist   $240.00
2023-04-26    Health    Medical supplies   $48.56
2023-04-30    Health    Insurance   $753.57
2023-05-01    Health    Insurance   $897.00
2023-05-31    Health    Insurance   $753.57
2023-06-01    Health    Insurance   $897.00
2023-06-30    Health    Insurance   $753.57
Total expenses   $5277.38
Less advances   $0.00
Reinbursement due   $5277.38

* - 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: