| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| TAX PREPERATION | 1,678 | 1,678 |
| 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 |
|---|---|---|---|---|---|---|---|---|---|
| TRACTOR & SNOW PLOW | 2008-05-15 | 2,244 | 2,050 | 200DB | 5.0000 | 129 | 129 |
| Name | Date Acquired | How Acquired | Date Sold | Purchaser Name | Gross Sales Price | Basis | Basis Method | Sales Expenses | Total (net) | Accumulated Depreciation |
|---|---|---|---|---|---|---|---|---|---|---|
| FORM 6252, LONG-TERM GAIN/LOSS | 46,859 | 46,859 |
| Name of Bond | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| ORRSTOWN FORWARD BALANCED | 37,484 | 38,126 |
| HD VEST MUTUAL FUND | 2,128 | 2,035 |
| 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 | 2,179 | 65 | 65 |
| Item No. | 1 |
|---|---|
| Lender's Name | ORRSTOWN BANK |
| Lender's Title | |
| Relationship to Insider | N/A |
| Original Amount of Loan | 650000 |
| Balance Due | |
| Date of Note | 2003-12 |
| Maturity Date | 2020-06 |
| Repayment Terms | MONTHLY PAYMENTS OF 1,800 |
| Interest Rate | 0.0325 |
| Security Provided by Borrower | LAND & BUILDINGS |
| Purpose of Loan | PURCHASE OF PROPERTY |
| Description of Lender Consideration | |
| Consideration FMV |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXPENSES | ||||
| INVESTMENT ADVISORY FEES | 470 | 470 | ||
| MISCELLANEOUS | 2,009 | 2,009 | ||
| INSURANCE | 162 | 162 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| NICKLAS, LLC | 31,352 | 31,352 |
| 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 | 2011-08 | 1931-08 | MONTHLY PAYMENTS OF 5,174 | 5.00 % | 100 SUNSET BLVD | PURCHASE OF REAL ESTATE | |||
| NICKLAS LLC | N/A | 609,298 | 602,045 | 2012-05 | 1937-05 | MONTHLY PAYMENTS OF 3,561 | 5.00 % | 100 SUNSET BLVD | PURCHASE OF REAL ESTATE | 602,045 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FEDERAL EXCISE TAX | 947 | 947 | ||
| UNRELATED BUSINESS TAX | 1,160 | |||
| 904 |