| Identifier | Return Reference | Explanation |
|---|
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| PACIFIC LIFE - POLICY VF51918560 | 1,461,032 | 976,215 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Administrative Fees | 4,068 | 4,068 | ||
| Premium payment for foundationowned life insurance | 213,847 | |||
| State or Local Filing Fees | 25 | 25 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Estimated Tax for 2011 | 100 | 0 | 0 | 0 |
| Excise Tax for 2010 | 5 | 0 | 0 | 0 |