| Person Name | Explanation |
|---|---|
| DOUGLAS K ANDERSON | |
| SHELLEY M ANDERSON |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| DOMAIN SURGICAL | 100,000 | 100,000 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXPENSES | ||||
| BAD DEBT | 71,520 | 71,520 | 71,520 | |
| EARLY WITHDRAWAL PENALTIES | 354 | 354 | 354 |
| Borrower's Name | Relationship to Insider | Original Amount of Loan | Balance Due | Date of Note | Maturity Date | Repayment Terms | Interest Rate | Security Provided by Borrower | Purpose of Loan | Description of Lender Consideration | Consideration FMV |
|---|---|---|---|---|---|---|---|---|---|---|---|
| REGANHARDT RECEIVABLE | NONE | 75,000 | 2008-04 | 6 MONTHS RENEWABLE | 8.00 % | NONE | INVESTMENT RETURN | ||||
| CLARIAN PARTNERS RECEIVABLE | NONE | 100,000 | 106,590 | 2009-11 | REVOLVING LOC | 5.00 % | NONE | INVESTMENT RETURN | 100,000 |