| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| PACIFIC LIFE VARIABLE ANNUITY | AT COST | 0 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| LEGAL FEES | 4,000 | 0 | 4,000 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| OHIO FILING FEE | 200 | 0 | 200 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| PACIFIC LIFE ANNUITY | 6,544 | 6,544 | 6,544 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| RAYMOND JAMES INVESTMENT FEES | 658 | 658 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| 2009 TAXES | 157 | 0 | 0 | |
| 2009 FORM 4720 TAXES | 600 | 0 | 0 |