| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| PHIL GOSS, CPA, PC | 1,120 |
| Identifier | Return Reference | Explanation |
|---|
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| SEE STATEMENT | 383,461 | 130,278 | 253,183 |
| Item No. | 1 |
|---|---|
| Lender's Name | EXCHANGE BANK & TRUST |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 240000 |
| Balance Due | 130777 |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | BUILDINGS AND EQUIPMENT |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 2 |
|---|---|
| Lender's Name | CENTRAL NAT'L BANK OF ALVA |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 22000 |
| Balance Due | |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | BUILDINGS AND EQUIPMENT |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 3 |
|---|---|
| Lender's Name | ADVANTA |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 17000 |
| Balance Due | |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | UNSECURED |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 4 |
|---|---|
| Lender's Name | AMERICAN EXPRESS |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 3000 |
| Balance Due | |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | UNSECURED |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 5 |
|---|---|
| Lender's Name | CAPITAL ONE |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 5000 |
| Balance Due | |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | UNSECURED |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 6 |
|---|---|
| Lender's Name | CHASE |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 7500 |
| Balance Due | |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | UNSECURED |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 7 |
|---|---|
| Lender's Name | CITIBANK |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 25000 |
| Balance Due | |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | UNSECURED |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 8 |
|---|---|
| Lender's Name | DISCOVER |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 1200 |
| Balance Due | |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | UNSECURED |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 9 |
|---|---|
| Lender's Name | LOWES |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 2600 |
| Balance Due | |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | UNSECURED |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 10 |
|---|---|
| Lender's Name | WALMART DISCOVER |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 3500 |
| Balance Due | |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | UNSECURED |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 11 |
|---|---|
| Lender's Name | BANK OF AMERICA (LOC) |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 16500 |
| Balance Due | |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | UNSECURED |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 12 |
|---|---|
| Lender's Name | JOE MILSAPP |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 4000 |
| Balance Due | |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | UNSECURED |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| SUPPLIES AND GROCERIES | 5,111 | |||
| ADVERTISING | 212 | |||
| MEALS | 1,098 | |||
| ASSESSMENT EXPENSES | 2,814 | |||
| AUTOMOBILE EXPENSES | 8,671 | |||
| BANK CHARGES | 274 | |||
| TELEPHONE | 4,470 | |||
| TRAINING | 100 | |||
| EQUIPMENT RENT | 1,095 | |||
| OFFICE AND POSTAGE | 1,180 | |||
| MISCELLANEOUS | 1,262 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| COUNSELING AND THERAPY | 28,607 | ||
| MISCELLANEOUS INCOME | 25 | ||
| ENTRY FEES | 8,595 | ||
| INSURANCE REIMBURSEMENT | 18,268 |
| Category | Gross Sales | Cost of Goods Sold | Net (Gross Sales Minus Cost of Goods Sold) |
|---|---|---|---|
| CONTRACTED LABOR | 16,115 | 14,119 | 1,996 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| REAL ESTATE TAXES | 101 | 0 | 0 | 0 |