| 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 |
|---|
| Grantee's Name | Grantee's Address | Grant Date | Grant Amount | Grant Purpose | Amount Expended By Grantee | Any Diversion By Grantee? | Dates of Reports By Grantee | Date of Verification | Results of Verification |
|---|---|---|---|---|---|---|---|---|---|
|
MALINDA YOUNG |
|
2012-12-13 | 15,000 | UNINSURED MEDICAL EXPENSE FOR NEWBORN CHILD | 15,000 | NO |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|
| Description | Beginning of Year - Book Value | End of Year - Book Value | End of Year - Fair Market Value |
|---|---|---|---|
| DIVIDEND RECEIVABLE | 6,775 | 5,788 | 5,788 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| BANK CHARGES | 113 | 113 | ||
| FOREIGN TAX PAID | 62 | 62 | ||
| TAXABLE EXD - MALINDA YOUNG | 15,000 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| NON-DIVIDEND DISTRIBUTIONS | 312 | 312 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FRANCHISE TAX BOARD | 60 | |||
| ATTORNEY GENERAL REGISTRY | 50 | |||
| EXCISE TAXES | 1,179 | |||
| SECRETARY OF STATE | 40 |