| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| TAX PREPERATION | 850 | 850 |
| Person Name | Explanation |
|---|---|
| PAUL E LEHMAN | |
| SHIRELY U LEHMAN |
| Description of Property | Date Acquired | Cost or Other Basis | Prior Years' Depreciation | Computation Method | Rate / Life (# of years) |
Current Year's Depreciation Expense | Net Investment Income | Adjusted Net Income | Cost of Goods Sold Not Included |
|---|---|---|---|---|---|---|---|---|---|
| BUILDING | 2003-12-31 | 387,416 | 69,536 | S/L | 39.0000 | 5,795 | 5,795 | ||
| LAND | 2003-12-31 | 52,829 | |||||||
| PARKING LOT & FENCE | 2004-12-20 | 19,601 | 14,488 | 150DB | 15.0000 | 301 | 301 | ||
| TRACTOR & SNOW PLOW | 2008-05-15 | 2,244 | 1,921 | 200DB | 5.0000 | 129 | 129 | ||
| TRUCK W/SNOW PLOW | 2010-02-12 | 6,500 | 1,192 | S/L | 5.0000 | ||||
| ADDITIONAL PAVEMENT | 2010-09-24 | 3,590 | 60 | S/L | 15.0000 | 139 | 139 |
| Name | Date Acquired | How Acquired | Date Sold | Purchaser Name | Gross Sales Price | Basis | Basis Method | Sales Expenses | Total (net) | Accumulated Depreciation |
|---|---|---|---|---|---|---|---|---|---|---|
| TRUCK W/SNOW PLOW | 2010-02 | PURCHASE | 2011-01 | 6,500 | -5,308 | 1,192 | ||||
| PURCHASE | ||||||||||
| FORM 6252, LONG-TERM GAIN/LOSS | 2,064 | 2,064 |
| Name of Bond | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| ORRSTOWN FORWARD BALANCED | 36,895 | 35,072 |
| Category/ Item | Cost/Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| LOTS FOR RESALE | 41,584 | 41,584 | 41,584 |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| 2,244 | 2,050 | 194 | 194 |
| Item No. | 1 |
|---|---|
| Lender's Name | ORRSTOWN BANK |
| Lender's Title | |
| Relationship to Insider | N/A |
| Original Amount of Loan | 650000 |
| Balance Due | 163604 |
| Date of Note | 2003-12 |
| Maturity Date | 2020-06 |
| Repayment Terms | MONTHLY PAYMENTS OF 1,800 |
| Interest Rate | 0.0625 |
| Security Provided by Borrower | LAND & BUILDINGS |
| Purpose of Loan | PURCHASE OF PROPERTY |
| Description of Lender Consideration | |
| Consideration FMV |
| Description | Beginning of Year - Book Value | End of Year - Book Value | End of Year - Fair Market Value |
|---|---|---|---|
| CASH SURRENDER VALUE OF LIFE INS. | 6,734 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXPENSES | ||||
| INVESTMENT ADVISORY FEES | 504 | 504 | ||
| MISCELLANEOUS | 281 | 281 | ||
| INSURANCE | 18,000 | 18,000 | ||
| BANK FEES | 100 | 100 |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NICKLAS LLC | N/A | 784,000 | 776,323 | 2011-08 | 1931-08 | MONTHLY PAYMENTS OF 5,174 | 5.00 % | 100 SUNSET BLVD | PURCHASE OF REAL ESTATE | 776,323 |